Loading
Life sciences · Journal article
Journal of Anaesthesiology Clinical Pharmacology · September 10, 2026
Encouraging direction, but not yet definitive.
This single-blind RCT of 80 HNC patients found that a single 1000 mg IV ferric carboxymaltose dose produced a greater mean hemoglobin rise than daily oral ferrous fumarate (+2.07 vs +1.52 g/dL, P=0.002) over 4–6 weeks postoperatively. However, absolute Hb levels at the intended oncological therapy window were not significantly different between groups (10.94 vs 10.91 g/dL, P=0.907), and the trial did not demonstrate that IV iron shortened time to RIOT or achieved clinically superior outcomes.
Prospective, single-blind, randomized controlled trial. Head and neck cancer patients undergoing major resection and reconstruction surgery with postoperative day 1 hemoglobin <10 g/dL.. Intervention: Single dose of 1000 mg intravenous ferric carboxymaltose on postoperative day 1. Compared with: 200 mg daily oral ferrous fumarate via nasogastric tube. n = 80.
At 4–6 weeks, final Hb levels were not significantly different: Group A (oral) 10.91 ± 1.56 vs Group B (IV) 10.94 ± 1.05 g/dL; P = 0.907 IV ferric carboxymaltose achieved significantly higher mean Hb increase (+2.07 g/dL) compared to oral iron (+1.52 g/dL) from POD 1 to 4–6 weeks; P = 0.002 Both groups showed significant intragroup increase in Hb levels (P < 0.001)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should note that IV ferric carboxymaltose produced a modestly faster hemoglobin rise than oral iron, but this did not translate to superior hemoglobin levels at the intended oncological therapy timepoint (4–6 weeks). The clinical significance of the 0.55 g/dL absolute difference and whether IV iron meaningfully accelerates return to cancer treatment remains unclear; oral iron may remain reasonable despite lower adherence if final Hb levels are equivalent.
Single-centre RCT with clear methodology showing IV iron achieves greater absolute Hb rise than oral iron, but fails the primary endpoint of superior Hb at RIOT timepoint; result requires confirmation and clinical significance of the 0.55 g/dL difference is unclear.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should note that IV ferric carboxymaltose produced a modestly faster hemoglobin rise than oral iron, but this did not translate to superior hemoglobin levels at the intended oncological therapy timepoint (4–6 weeks). The clinical significance of the 0.55 g/dL absolute difference and whether IV iron meaningfully accelerates return to cancer treatment remains unclear; oral iron may remain reasonable despite lower adherence if final Hb levels are equivalent.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Background and Aims: Perioperative anemia is a critical barrier to Return to Intended Oncological Therapy (RIOT) in head and neck cancer (HNC) patients. Surgery-induced systemic inflammation triggers a hepcidin surge, causing functional iron deficiency that limits erythropoiesis and delays recovery. We compared the efficacy of a single postoperative dose of intravenous versus oral iron therapy in elevating hemoglobin (Hb) concentrations at RIOT, typically occurring within the 4–6 week postsurgical window. Material and Methods: In this prospective, single-blinded, randomized trial, 80 HNC patients who underwent major resection and reconstruction surgery with postoperative day (POD) 1 Hb <10 g/dL were recruited. Group A received 200 mg daily oral ferrous fumarate via nasogastric tube. Group B received a single dose of 1000 mg IV ferric carboxymaltose on POD 1. Results: At 4–6 weeks, intergroup analysis showed no significant difference in absolute Hb levels (Group A: 10.91 ± 1.56 vs. Group B: 10.94 ± 1.05 g/dL; P = 0.907). However, intragroup analysis revealed a significant increase in Hb levels in both arms ( P < 0.001). The intergroup comparison of increase in Hb levels from POD 1 to 4–6 weeks recovery period showed that Group B achieved a significantly higher mean Hb increase compared to Group A (+2.07 vs. +1.52 g/dL; P = 0.002). Conclusions: A single postoperative dose of 1000 mg IV ferric carboxymaltose showed no superiority over oral iron in 4–6 week Hb levels or RIOT timing. IV iron achieved a significantly higher mean Hb increase compared to oral iron (+2.07 vs. +1.52 g/dL), but oral adherence was low.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.