There was no increased risk of infections with IV iron .
Gastrointestinal AEs were reduced with IV iron .
CONCLUSION Intravenous iron therapy is not associated with an increased risk of SAEs or infections .
Infusion reactions are more pronounced with IV iron
OBJECTIVE To amass all available evidence regarding the safety of intravenous ( IV ) iron preparations to provide a true balance of efficacy and safety .
A randomized study of oral vs intravenous iron supplementation in patients with progressive renal insufficiency treated with erythropoietin.
BACKGROUND Correction of anaemia as a result of renal failure improves cardiovascular function and also provides significant cognitive and emotional benefits . The most appropriate route for iron supplementation has not been determined for patients with chronic renal failure who are not yet on dialysis . METHODS Forty-five anaemic patients with progressive renal insufficiency ( PRI ) were prospect ively r and omized to receive oral ( ferrous sulphate 200 mg tds ) or intravenous ( 300 mg iron sucrose monthly ) iron treatment . Erythropoietin ( rHuEpo ) was simultaneously commenced and the dose adjusted according to a pre-established protocol . RESULTS There were no significant differences in baseline patient characteristics between the two groups . The average follow-up was 5.2 months . Three patients suffered possible allergic reactions to iron sucrose . Haemoglobin response and changes in red cell hypochromasia were similar in the two groups , but serum ferritin was significantly higher in the intravenous group . The starting dose of rHuEpo could be temporarily discontinued in 43 % of patients on oral iron and 33 % of patients receiving iron sucrose ( NS ) . rHuEpo was increased after 3 months in 9 % of patients on oral iron and 19 % of patients receiving iron sucrose ( NS ) . Final doses of rHuEpo were 33.5 ( 0 - 66 ) and 41.6 ( 0 - 124 ) U/kg/week respectively in the oral and intravenous groups ( NS ) . Although gastro-intestinal symptoms were more commonly reported in patients taking oral iron , these were mild according to scores on visual analogue scales . Dietary protein and energy intake were not significantly different in the two groups at 0 , 3 and 6 months . CONCLUSIONS In pre-dialysis patients , the efficacy of monthly 300 mg iron sucrose given intravenously is not superior with regard to haemoglobin response and rHuEpo dose as compared with a daily oral dose of 600 mg of ferrous sulphate or equivalent . Where intravenous iron is preferred , lower doses may help to reduce the incidence of allergic or " free iron " reactions , especially in patients with low body mass
There was no increased risk of infections with IV iron .
Gastrointestinal AEs were reduced with IV iron .
CONCLUSION Intravenous iron therapy is not associated with an increased risk of SAEs or infections .
Infusion reactions are more pronounced with IV iron
OBJECTIVE To amass all available evidence regarding the safety of intravenous ( IV ) iron preparations to provide a true balance of efficacy and safety .