Повышение гемоглобина на менее 10 г/л через 2 недели лечения ЖДА пероральными препаратами железа может быть хорошим индикатором плохого ответа на лечение и последуюшим назначением таким пациентам в/в введения железа - доля таких пациентов в среднем 27% :
Pooled data from 5 randomized trials were analyzed to compare oral and IV iron-replacement therapy for iron-deficiency anemia. Treatment criteria and assignment to oral versus IV iron were defined per protocol; this analysis included only subjects receiving oral iron. Responders were subjects with ≥1.0 g/dL increases in hemoglobin at day 14, and nonresponders were those with smaller increases. Demographic and clinical characteristics were evaluated for association with hemoglobin response at multiple timepoints.
Most subjects (72.8%) were classified as responders. The proportion of subjects with hemoglobin increases ≥1.0, ≥2.0, and ≥3.0 g/dL was greatest among those with postpartum anemia, intermediate among those with heavy uterine bleeding or gastrointestinal-related causes of anemia, and lowest among those with other causes; this proportion was also significantly greater among responders than nonresponders. A ≥1.0 g/dL increase in hemoglobin on day 14 most accurately predicted satisfactory overall hemoglobin response to oral iron on day 42/56 (sensitivity: 90.1%; specificity: 79.3%; positive and negative predictive values: 92.9% and 72.7%, respectively). Iron-replacement therapy improved quality of life and reduced fatigue.
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Am J Med. 2017 Apr 25. pii: S0002-9343(17)30389-3.
Iron supplementation, response in iron-deficiency anemia: analysis of five trials.
Okam MM, Koch TA, Tran MH.
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