Intravenous Iron Therapies for Deficiency Anemia

Iron deficiency anaemia arises when iron supply fails to meet the demands of erythropoiesis, leading to reduced haemoglobin synthesis and impaired oxygen delivery. While oral iron remains first-line, gastrointestinal intolerance, malabsorption and inflammation often limit its efficacy. Intravenous iron therapies bypass these barriers, delivering iron-carbohydrate complexes—such as iron sucrose, ferric carboxymaltose and iron isomaltoside—that differ in molecular weight, ligand stability and release kinetics. These properties govern pharmacokinetics, dosing regimens and safety profiles, enabling single-dose administration in settings ranging from chronic kidney disease and heart failure to gynaecological disorders and perioperative care. Although rapid repletion improves symptoms and quality of life, there is a risk of hypersensitivity reactions, oxidative stress and hypophosphataemia mediated by altered phosphate handling. Emerging studies use advanced imaging and proteomic techniques to link nano-structural features with protein interactions and macrophage processing, while clinical investigations refine dosing strategies and long-term management. Globally, intravenous iron has transformed the treatment landscape, offering tailored options that optimise iron delivery and minimise adverse effects across diverse patient populations.

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Intravenous Iron Therapies for Deficiency Anemia publication trend

The graph below shows the total number of articles in intravenous iron therapies for deficiency anemia across all publications each year (not limited to Nature Index journals).

Technical terms

Iron-carbohydrate complex: Colloidal iron formulations comprising an iron(III) oxide core stabilised by carbohydrate ligands, designed for controlled release after intravenous administration.

Erythropoiesis: Process of red blood cell production in the bone marrow, requiring bioavailable iron for haemoglobin synthesis.

Ferritin: Intracellular protein that safely stores iron and releases it in a regulated manner to maintain cellular iron homeostasis.

Transferrin saturation: Fraction of the iron-binding sites of the plasma protein transferrin occupied by iron, indicating circulating iron availability.

Hypophosphataemia: Clinical condition characterised by abnormally low serum phosphate levels, which can occur as an adverse effect of certain intravenous iron formulations.

References

1. Iron-carbohydrate complexes treating iron anaemia: Understanding the nano-structure and interactions with proteins through orthogonal characterisation. Journal of Controlled Release (2024).
2. Uncovering the dynamics of cellular responses induced by iron-carbohydrate complexes in human macrophages using quantitative proteomics and phosphoproteomics. Biomedicine & Pharmacotherapy (2023).
3. Efficacy and Safety of Intravenous Ferric Carboxymaltose Treatment of Iron Deficiency Anaemia in Patients with Corpus Atrophic Gastritis: A Retrospective Study. Nutrients (2023).