Iron sucrose 100mg/5ml solution for injection vials

Background objectivesIron deficiency anaemia (IDA) during pregnancy is treated with oral and parenteral iron. The objective of this review was to compare the clinical effectiveness, safety, pregnancy and neonatal outcomes of intravenous (iv) ferric carboxymaltose (FCM) and iv iron sucrose (IS) in treating IDA in pregnancy.MethodsThe Department of Health Research funded this study. PubMed, Cochrane Library, EMBASE and Scopus were searched to include studies published till November 2022. The protocol was registered in PROSPERO (CRD42022306092). Pregnant women (15-49 yr) in second and third trimesters, diagnosed with moderate-to-severe iron deficiency anaemia, treated with either of the drugs were included. The included studies were critically assessed using appropriate tools. We conducted a qualitative synthesis of the studies and meta-analysis for improvement in haematological parameters and incidence of adverse events.ResultsA total of 18 studies were included. The risk of bias was low to moderate. A rise in haemoglobin up to four weeks was higher with FCM than IS by 0.57 (0.24, 0.9) g/dl. Intravenous FCM is associated with fewer adverse events than IS [pooled odds ratio: 0.5 (0.32, 0.79)]. The included studies had limited evidence on pregnancy and neonatal outcomes after iv iron treatment.Interpretation conclusionsIntravenous FCM is effective and safer than intravenous IS in terms of haematological parameters, in treating IDA in pregnancy. Further research is required on the effects of iv FCM and iv IS on the pregnancy and neonatal outcomes when used for treating IDA in pregnancy.

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ObjectiveThis study comprehensively compares the efficacy, safety, and tolerability of two commonly used intravenous iron preparations, ferric carboxymaltose (FCM) and iron sucrose (IS), in adult patients with iron-deficiency anemia (IDA).Materials and methodsA systematic literature search was conducted across the PubMed, Ovid MEDLINE, Web of Science, and Cochrane Library databases up to January 1, 2024, to identify randomized controlled trials directly comparing FCM and IS treatments in adult patients with IDA. The primary outcome of interest was change in hemoglobin (Hb) levels during follow-up. Meta-analyses were conducted with inverse variance random effects models.ResultsFourteen trials were included in the study, with a total of 4757 patients. FCM resulted in a non-significant increase in Hb levels (mean difference [MD]: 0.45 g/dL, 95% confidence interval [CI]: 0.08 to 0.83, p=0.02) and ferritin levels (MD: 37.32 ng/mL, 95% CI: 18.98 to 55.65, pConclusionTen studies showed some concerns of risk of bias (RoB) and four studies had a high RoB for the change in Hb levels during follow-up. The lack of standardized definitions for hypersensitivity reactions and variability in dosing protocols and follow-up durations across studies may affect the generalizability of our safety findings.

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Iron deficiency is a distinct comorbidity in patients with heart failure (HF), independent of anemia, and is associated with reduced functional capacity and increased hospitalization and mortality. Randomized trials of intravenous (IV) iron repletion have yielded directionally consistent but incompletely aligned results, prompting numerous systematic reviews and meta-analyses that largely draw on the same underlying trials. We performed an umbrella review to consolidate this evidence base and clarify the strength and consistency of treatment effects across outcomes. Across the pooled reviews, IV iron, predominantly ferric carboxymaltose (FCM), reduced the composite risk of HF hospitalization and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF), an effect attributable chiefly to fewer hospitalizations rather than a survival benefit, which remained non-significant throughout. Functional capacity, symptom class, and quality of life improved consistently. Safety appeared favorable among the outcomes formally assessed, though fewer than half of the included reviews performed a dedicated statistical safety analysis, and known formulation-specific risks such as hypophosphatemia were not evaluated in this literature. The treatment effect appeared attenuated in the one review restricted to acute heart failure, and possible differences in benefit by sex and by baseline iron-transport capacity emerged as hypothesis-generating candidate explanations for residual heterogeneity, warranting prospective confirmation rather than immediate clinical application. Evidence was drawn predominantly from FCM trials, with more limited supporting data for ferric derisomaltose and minimal data for other formulations; findings should not be extrapolated beyond HFrEF, as HF with preserved ejection fraction populations were not separately represented in this literature. Because the available reviews draw heavily on a shared and aging set of trials (corrected covered area of 31.9%, indicating very high primary-study overlap), this synthesis should be regarded as clarifying rather than expanding the evidence base. Taken together, IV iron repletion, particularly with FCM, in iron-deficient HFrEF reduces hospitalizations and improves quality of life, but a mortality benefit has not been established, underscoring the need for adequately powered trials designed specifically to resolve this question.

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IntroductionThe efficacy of iron isomaltoside ferumoxytol versus iron sucrose to treat iron deficiency anemia remains controversial. We conduct this meta-analysis to explore the influence of iron isomaltoside ferumoxytol versus iron sucrose on iron deficiency anemia.MethodsWe have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2021 for randomized controlled trials (RCTs) assessing the effect of iron isomaltoside ferumoxytol versus iron sucrose on iron deficiency anemia. Meta-analysis was performed using the random-effect model.ResultsFour RCTs involving 3892 patients were included in the meta-analysis. Overall, compared with iron sucrose for iron deficiency anemia, iron isomaltoside showed similar change of Hb (SMD=0.14; 95% CI=-0.07 to 0.35; P=0.18), Hb responder (SMD=1.41; 95% CI=0.71 to 2.81; P=0.33), serum ferritin (SMD=15.13; 95% CI=-23.45 to 53.71; P=0.44), and transferrin saturation (SMD=1.20; 95% CI=-1.08 to 3.47; P=0.30). However, iron isomaltoside further improved serum-ferritin at week 2 than iron sucrose (SMD=204.79; 95% CI=38.23 to 371.35; P=0.02).ConclusionsIron isomaltoside ferumoxytol showed comparable efficacy to iron sucrose for the treatment of iron deficiency anemia.

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Background Iron deficiency affects nearly half of patients with heart failure with reduced ejection fraction and is associated with impaired functional capacity, recurrent hospitalizations, and increased mortality. Intravenous iron therapy improves exercise tolerance, but the comparative effectiveness of different formulations remains uncertain. Objectives To compare the efficacy of ferric carboxymaltose, ferric derisomaltose, and iron sucrose in patients with heart failure with reduced ejection fraction and iron deficiency using a network meta-analysis. Methods We systematically searched PubMed, the Cochrane Central Register of Controlled Trials, and Web of Science through August 2025 for randomized controlled trials of intravenous ferric carboxymaltose, ferric derisomaltose, or iron sucrose versus placebo. Fifteen randomized controlled trials published between 2007 and 2025 enrolling 7,761 patients were included. The primary outcomes were hospitalization for heart failure, all-cause mortality, and cardiovascular mortality. Secondary outcomes included change in six-minute walk distance, serum ferritin, and transferrin saturation. A frequentist random-effects network meta-analysis was performed, and treatment rankings were assessed using surface under the cumulative ranking curve probabilities. Results Twelve trials reported hospitalization for heart failure, showing significant reduction with ferric carboxymaltose (risk ratio 0.80, 95% confidence interval 0.69–0.92) and nonsignificant trends with ferric derisomaltose (0.80, 0.61–1.04) and iron sucrose (0.41, 0.15–1.07). No formulation reduced all-cause or cardiovascular mortality. Functional capacity improved with all formulations (mean difference +21.1 to +54.0 meters versus placebo), though heterogeneity was high. Ferritin and transferrin saturation increased significantly across all formulations, with the largest ferritin gain from ferric derisomaltose (+329 µg/L) and the most consistent transferrin saturation improvement from ferric carboxymaltose (+7.1%). Conclusions In patients with heart failure with reduced ejection fraction and iron deficiency, intravenous iron therapy—particularly ferric carboxymaltose—reduces hospitalization for heart failure, improves functional capacity, and corrects iron indices. Mortality benefits remain uncertain. These findings support guideline-endorsed use of intravenous iron, with ferric carboxymaltose as the best-studied option, while further outcome data for ferric derisomaltose and iron sucrose are needed.

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