Effect of IV ferric carboxy maltose for moderate/severe anemia: a systematic review and meta-analysis

Introduction

Anemia remains a prevalent global health issue with varying severity. Intravenous iron supplementation, particularly with ferric carboxymaltose (FCM), has appeared as a possible therapeutic intervention for individuals with moderate to severe anemia. The study aimed to assess the efficacy and safety of ferric carboxymaltose (FCM) in reducing anemia.

Methods

We searched electronic databases, registries, websites, e-libraries, reference lists of reviews, citations, etc. We included randomized control trials (RCTs), non-RCTs, and single-arm studies, while observational studies, case series, and case studies were excluded. Two reviewers independently screened the studies and extracted the data. We included studies of moderate-to-severely anemic Indians and excluded Indians with other comorbidities. We assessed the risk of bias and the overall quality of evidence (QoE) using GRADE GDT.

Result

We identified 255 studies and included 14 studies (11 RCT, one non-RCT, and two single-arm studies) with 1,972 participants for qualitative analysis and 10 studies in the meta-analysis. All the included studies detailed the use of FCM for anemia. The primary outcomes assessed in the included studies were anemia, hemoglobin, and adverse events. The outcomes assessed ranged from 2 weeks to 12 weeks. The risk of bias varied across different studies with different outcomes. FCM is consistent with a fewer number of adverse events as compared to other interventions and provides "moderate" to "very low" QoE.

Conclusion

A slow single infusion of 1 gram of FCM is well-tolerated, safe, and effective in treating iron deficiency anemia (IDA) and surpasses other interventions (Iron Sucrose Complex (ISC), Iron sucrose, and ferrous ascorbate) in elevating hemoglobin levels and replenishing iron stores.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=459363, CRD42023459363.

The Impact of Parental Substance Abuse and Psychosocial Behaviour of Children in Age Group of 6-12 years: School Based Study

Aim of the study is 1. Find out the extent of reported parental substance abuse 2. Assess the psychosocial development of child 3. Assess the perceived impact of parental substance abuse on psychosocial development of children. Methodology: The study was conducted in the school of Wardha district, Maharashtra, India. Population: School going children of age 6-12yrs and their parents. 200 sample size was selected, each 100 parent and 100 children. Non-probability convenient sampling technique used.  A structured questionnaire used for both parent and their children separately. Results: The reported prevalence rate of parental substance abuse as reported by children shows the ratio as: The rate of no substance abusers which scores from 0-12 of frequency (14) is 14%.The rate of Borderline abusers which scores from 13-24 of frequency (23) is 23%. The rate of Mild abusers which scores from 25-36 of frequency (22) is 22%.The rate of Moderate abusers which scores from 37-48 of frequency (23) is 23%.The rate of Severe abusers which scores from 49-60 of frequency (18) is 18%. The reported prevalence rate of parental substance abuse as reported by parent shows the ratio as: The rate of no substance abusers which scores from 0-9 of frequency (6) is 6%. The rate of Borderline abusers which scores from 10-18 of frequency (24) is 24%. The rate of Mild abusers which scores from 19-27 of frequency (28) is 28%. The rate of Moderate abusers which scores from 28-36 of frequency (18) is 18%. The rate of Severe abusers which scores from 37-44 of frequency (26) is 26%. Psychosocial behaviour of children which reveals that most of the children will act as crying or will get angry which is an age appropriate behaviour.