COMPARISON OF FERROUS SULPHATE AND IRON POLYMALTOSE COMPLEX IN CHILDREN FOR THE TREATMENT OF IRON DEFICIENCY ANEMIA

M AMJAD; IU HAQ; Q ALI

doi:10.54112/pjicm.v5i02.167

Authors

M AMJAD Department of Paediatric Medicine, Saidu Group of Teaching Hospital Saidu Sharif Swat, Pakistan
IU HAQ Department of Paediatric Medicine, Saidu Group of Teaching Hospital Saidu Sharif Swat, Pakistan
Q ALI Department of Pulmonology, Saidu Group of Teaching Hospital, Saidu Sharif, Swat, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.167

Keywords:

Ferrous Sulphate, Iron Polymaltose Complex, Anemia, Serum Ferritin, Iron Deficiency Anemia

Abstract

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency in children worldwide. Oral iron therapy remains the cornerstone of treatment, with ferrous sulphate and iron polymaltose complex (IPC) commonly prescribed. However, their comparative efficacy remains a matter of debate. Objective: To compare the effectiveness of ferrous sulphate and iron polymaltose complex in children for the treatment of IDA. Study Design: Randomized controlled trial. Setting: Department of Pediatrics at Saidu Group of Teaching Hospitals, Swat, Pakistan. Duration of Study: 21 July 2024 to 21 January 2025. Methods: A total of 72 children aged 2–10 years with confirmed IDA were enrolled and randomly allocated into two equal groups. Group A received oral ferrous sulphate at 6 mg/kg/day, while Group B was administered an equivalent dose of IPC. Treatment efficacy was defined as achieving a hemoglobin level of≥10.5 g/dL and a serum ferritin level of>15 ng/mL after four weeks of therapy. Data were analyzed using SPSS version 25, and the chi-square test was applied; P < 0.05 was considered statistically significant. Results: The mean age of children in Group A was 5.42 ± 2.51 years, while in Group B it was 6.47 ± 2.36 years. Treatment efficacy was achieved in 88.9% of children in the ferrous sulphate group compared to 63.9% in the IPC group (P = 0.01). Conclusion: Ferrous sulphate was significantly more effective than iron polymaltose complex in improving hematological parameters among children with IDA, supporting its role as the preferred first-line oral therapy.

References

Leung AK, Lam JM, Wong AH, Hon KL, Li X. Iron deficiency anemia: an updated review. Curr Pediatr Rev. 2024;20(3):339–56. https://doi.org/10.2174/1573396320666230727102042

World Health Organization. Nutritional Anaemias: Tools for Effective Prevention and Control. Geneva: WHO; 2017.

Cerami C. Iron nutriture of the fetus, neonate, infant, and child. Ann Nutr Metab. 2017;71(3):8–14. https://doi.org/10.1159/000481447

Sangkhae V, Nemeth E. Regulation of the iron homeostatic hormone hepcidin. Adv Nutr. 2017;8(1):126–36. https://doi.org/10.3945/an.116.013961

Donovan A, Roy CN, Andrews NC. The ins and outs of iron homeostasis. Physiology (Bethesda). 2006;21(2):115–23. https://doi.org/10.1152/physiol.00052.2005

Gkouvatsos K, Papanikolaou G, Pantopoulos K. Regulation of iron transport and the role of transferrin. Biochim Biophys Acta Gen Subj. 2012;1820(3):188–202. https://doi.org/10.1016/j.bbagen.2011.10.013

Vogt AC, Arsiwala T, Mohsen M, Vogel M, Manolova V, Bachmann MF. On iron metabolism and its regulation. Int J Mol Sci. 2021;22(9):4591. https://doi.org/10.3390/ijms22094591

El-Hawy MA, Abd Al-Salam SA, Bahbah WA. Comparing oral iron bisglycinate chelate, lactoferrin, and iron polymaltose complex in the treatment of children with iron deficiency anemia. Clin Nutr ESPEN. 2021;46:367–71. https://doi.org/10.1016/j.clnesp.2021.10.019

Rosli RR, Norhayati MN, Ismail SB. Effectiveness of iron polymaltose complex in treatment and prevention of iron deficiency anemia in children: a systematic review and meta-analysis. PeerJ. 2021;9:e10527. https://doi.org/10.7717/peerj.10527

Chavan S, Rana P, Tripathi R, Tekur U. Comparison of efficacy and safety of iron polymaltose complex and ferrous ascorbate with ferrous sulphate in pregnant women with iron-deficiency anaemia. Indian J Med Res. 2021;154(1):78–84. https://doi.org/10.4103/ijmr.IJMR_1753_18

Alexiadou S, Tsigalou C, Kourkouni E, Tsalkidis A, Mantadakis E. Oral iron-hydroxide polymaltose complex versus sucrosomial iron for children with iron deficiency with or without anemia: a clinical trial with emphasis on intestinal inflammation. Mediterr J Hematol Infect Dis. 2024;16(1):e2024075. https://doi.org/10.4084/MJHID.2024.075

Zaman S, Khan MM, Tabussam S, Nawaz S, Ayub A, Shah SA. Comparison of ferrous sulfate versus iron polymaltose complex in the treatment of iron deficiency anemia in children. Pak J Med Health Sci. 2022;16(10):308–10. https://doi.org/10.53350/pjmhs221610308

Bakht S, Ikram M, Shirazi SS, Saif OB, Rehman FU, Saif A. Comparison of efficacy and tolerability of iron polymaltose complex with ferrous sulphate in treatment of children with iron deficiency anemia. Rawal Med J. 2022;47(3):608–9.

Siraj K, Naz F, Mahsood S, Ali H, Shafiq F, Nawaz S, et al. Efficacy of ferrous sulfate in the management of iron deficiency anemia in children. Cureus. 2025;17(5):e84826. https://doi.org/10.7759/cureus.84826

Bopche AV, Dwivedi R, Mishra R, Patel GS. Ferrous sulfate versus iron polymaltose complex for treatment of iron deficiency anemia in children. Indian Pediatr. 2009;46(10):883–5.