Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
ABSTRACT Background & Objective Few trials have compared the efficacy of intravenous (IV) iron repletion to oral repletion for patients with gastrointestinal bleeding (GIB). We aim to guide clinical decision‐making and optimize treatment strategies through the findings from these studies to prov...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-07-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.70225 |
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| Summary: | ABSTRACT Background & Objective Few trials have compared the efficacy of intravenous (IV) iron repletion to oral repletion for patients with gastrointestinal bleeding (GIB). We aim to guide clinical decision‐making and optimize treatment strategies through the findings from these studies to provide a step closer to a consensus on the most effective approach to iron supplementation for patients with GIB. Methods A systematic review and meta‐analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Embase, CENTRAL, Scopus, and Web of Science from inception to April 2024. We used the fixed‐effects model to report dichotomous outcomes using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI). PROSPERO ID: CRD42024542759. Results Three RCTs that included 254 patients were included. IV iron was significantly associated with increased complete response (RR: 1.60 with 95% CI [1.24, 2.07], p < 0.01) compared to oral iron, with no significant difference between IV iron and oral iron in partial response (RR: 2.13 with 95% CI [0.60, 7.50], p = 0.24). IV iron was significantly associated with increased Hb concentration (MD: 1.45 g/dL with 95% CI [0.50, 2.40], p < 0.01) and ferritin change (MD: 220.02 μg/L with 95% CI [22.31, 417.73], p = 0.03) compared to oral iron. However, there was no significant difference between IV and oral iron in transferrin saturation (MD: 4.71% with 95% CI [−5.96, 15.38], p = 0.39). Conclusion With uncertain evidence, IV iron demonstrated increased hemoglobin and ferritin concentrations and achieved complete response rates in patients with GIB. |
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| ISSN: | 2397-9070 |