Date Published: 
Friday, 11 July, 2014

Iron therapy improves quality of life in women with iron deficiency anaemia and abnormal uterine bleeding, research reveals

Professor Jorge Toblli

New study data indicate that intravenous iron may improve health-related quality of life in women who have iron deficiency anaemia caused by abnormal uterine bleeding. In addition, treatment with ferumoxytol, where oral iron has previously been unsuccessful, increases haemoglobin levels in this patient group, according to the researchers.

Untreated, iron deficiency anaemia can result in fatigue and reductions in day-to-day quality of life. Recommendations currently indicate treatment with either oral or intravenous iron. However, oral iron is often intolerable or inefficacious. This double-blind study evaluated the effect of intravenous iron on quality of life in women with abnormal uterine bleeding, which had led to iron deficiency anaemia.

Patients (n=344) with iron deficiency anaemia (7–10 g/dL haemoglobin, transferrin saturation <20%) and abnormal uterine bleeding, who had been unsuccessfully treated with oral iron, were randomised to two injections of 510 mg ferumoxytol or placebo. Health-related quality of life was assessed at Week 5 (Functional Assessment of Chronic Illness Therapy-Fatigue Scale [FACIT-F], Linear Analog Scales Energy, and SF-36-Vitality), in addition to efficacy and safety endpoints.

Patients treated with ferumoxytol demonstrated significantly greater improvements than placebo at all post-baseline time points, including FACIT-F (13.3 vs 7.0; p<0.001), SF-36- Vitality (11.7 vs 7.0; p<0.004), and Linear Analog Scales Energy (23.8 vs 11.1, respectively; p<0.001). Mean haemoglobin increased by 2.8 g/dL in patients treated with iron therapy compared with 0.0 g/dL in the placebo group (p<0.001).

The authors highlight the benefit of treating this patient group with intravenous iron versus oral iron therapy. They conclude that intravenous administration of ferumoxytol appears effective and safe for women with iron deficiency anaemia caused by abnormal uterine bleeding. Moreover, health-related quality of life in this group of patients was substantially improved.

Previous studies using ferric carboxymaltose have demonstrated similar outcomes in women with iron deficiency anaemia. This new study reinforces the advantages of intravenous iron versus oral iron therapy for this important and frequent deficiency in women.

The full article is available in the May 2014 issue of Obstetrics and Gynecology, among the abstracts presented at the American Congress of Gynecology. For information on iron deficiency in the obstetrics and gynaecological setting, please click here.