Dhanvijay Anupkumar D, Patidar Vipin, Singh Jayvardhan, Kumar Subodh, Mudgal Shiv Kumar, Varikasuvu Seshadri Reddy, Kumar Rajesh
Department of Physiology, All India Institute of Medical Sciences, Deoghar, India.
College of Nursing, All India Institute of Medical Sciences, Deoghar, India.
BMC Pharmacol Toxicol. 2025 Aug 21;26(1):152. doi: 10.1186/s40360-025-00984-2.
Iron deficiency anemia (IDA) remains a prevalent global health issue. While oral iron therapy is the first-line treatment, the optimal dosing strategy-daily versus alternate-day-remains debated, especially for general population use. Therefore, this review aimed to compare the efficacy and tolerability of daily versus alternate-day oral iron supplementation for IDA in the general population.
Searches were conducted across major databases through March 2025. Risk of bias was evaluated utilizing the Cochrane RoB 2 tool, and the certainty of evidence was graded using GRADE. The primary outcome was change in hemoglobin concentration; secondary outcomes included serum iron, ferritin, transferrin saturation, TIBC, MCV, and adverse events. R Studio software, version 4.2.3, and RevMan used for all analyses.
This SRMA (systematic review and meta-analysis) included 11 RCTs involving 1014 participants. The pooled analysis found a small, statistically non-significant increase in hemoglobin with daily dosing over alternate-day (MD: 0.28, 95% CI: -0.01 to 0.56, p = 0.06, z = 1.91). Secondary outcomes revealed no significant differences among groups for serum iron, ferritin, transferrin saturation, TIBC, and MCV. Adverse effects were similar between groups (RR: 1.07, 95% CI: 0.86 to 1.34), though metallic taste was more frequent with daily dosing. Risk of bias was low to moderate across studies. Certainty of evidence was rated very low for most outcomes due to heterogeneity and imprecision.
Both daily and alternate-day oral iron supplementation are comparably effective for treating IDA, with alternate-day dosing showing better tolerability. Due to low certainty in evidence, treatment decisions should be individualized pending further high-quality research.
Not applicable.
缺铁性贫血（IDA）仍是一个普遍存在的全球健康问题。虽然口服铁剂治疗是一线治疗方法，但最佳给药策略——每日给药与隔日给药——仍存在争议，尤其是在一般人群中的应用。因此，本综述旨在比较一般人群中每日口服铁剂与隔日口服铁剂治疗IDA的疗效和耐受性。
检索截至2025年3月的各大数据库。使用Cochrane RoB 2工具评估偏倚风险，并使用GRADE对证据的确定性进行分级。主要结局是血红蛋白浓度的变化；次要结局包括血清铁、铁蛋白、转铁蛋白饱和度、总铁结合力、平均红细胞体积和不良事件。所有分析均使用R Studio软件4.2.3版和RevMan。
本系统评价和荟萃分析纳入了11项随机对照试验，涉及1014名参与者。汇总分析发现，每日给药组的血红蛋白水平较隔日给药组有小幅升高，但在统计学上无显著差异（平均差：0.28，95%置信区间：-0.01至0.56，p = 0.06，z = 1.91）。次要结局显示，各组在血清铁、铁蛋白、转铁蛋白饱和度、总铁结合力和平均红细胞体积方面无显著差异。两组的不良反应相似（风险比：1.07，95%置信区间：0.86至1.34），不过每日给药时金属味更常见。各研究的偏倚风险为低到中度。由于存在异质性和不精确性，大多数结局的证据确定性被评为极低。
每日口服铁剂和隔日口服铁剂治疗IDA的效果相当，隔日给药的耐受性更好。由于证据的确定性较低，在有进一步高质量研究之前，治疗决策应个体化。
不适用。
