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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Wiley
2025-07-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.70225 |
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| author | Mohamed Abuelazm Ahmed Fares Mohammad Adam Yazan Sallam Ahmed Mazen Amin Hosam I. Taha Mustafa Turkmani Fouad Jaber |
| author_facet | Mohamed Abuelazm Ahmed Fares Mohammad Adam Yazan Sallam Ahmed Mazen Amin Hosam I. Taha Mustafa Turkmani Fouad Jaber |
| author_sort | Mohamed Abuelazm |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-e807b4d8171d44669684604837f3d867 |
| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj-art-e807b4d8171d44669684604837f3d8672025-08-20T03:32:11ZengWileyJGH Open2397-90702025-07-0197n/an/a10.1002/jgh3.70225Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled TrialsMohamed Abuelazm0Ahmed Fares1Mohammad Adam2Yazan Sallam3Ahmed Mazen Amin4Hosam I. Taha5Mustafa Turkmani6Fouad Jaber7Faculty of Medicine Tanta University Tanta EgyptDivision of Gastroenterology and Hepatology Henry Ford Hospital Detroit Michigan USADepartment of Internal Medicine University of Missouri‐Kansas City Kansas City USADepartment of Internal Medicine University of Missouri‐Kansas City Kansas City USAFaculty of Medicine, Mansoura University Mansoura EgyptFaculty of Medicine Tanta University Tanta EgyptFaculty of Medicine Michigan State University East Lansing Michigan USADivision of Gastroenterology and Hepatology Baylor College of Medicine Houston Texas USAABSTRACT 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.https://doi.org/10.1002/jgh3.70225anemiahemorrhagetransfusionvaricealvarices |
| spellingShingle | Mohamed Abuelazm Ahmed Fares Mohammad Adam Yazan Sallam Ahmed Mazen Amin Hosam I. Taha Mustafa Turkmani Fouad Jaber Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials JGH Open anemia hemorrhage transfusion variceal varices |
| title | Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_full | Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_fullStr | Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_short | Intravenous Versus Oral Iron After Gastrointestinal Bleeding: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials |
| title_sort | intravenous versus oral iron after gastrointestinal bleeding a systematic review and meta analysis of randomized controlled trials |
| topic | anemia hemorrhage transfusion variceal varices |
| url | https://doi.org/10.1002/jgh3.70225 |
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