Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial

Abstract Background Iron deficiency anemia (IDA) remains one of the leading causes of childhood morbidity worldwide. Conventional therapy with ferrous sulfate is often limited by gastrointestinal (GI) side effects and poor adherence. Ferric pyrophosphate (FPP), a newer iron formulation, promises imp...

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Main Authors: Inderdeep Singh Kochar, Dilpreet Kaur, Money Sachdeva
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:Egyptian Pediatric Association Gazette
Subjects:
Online Access:https://doi.org/10.1186/s43054-025-00412-4
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author Inderdeep Singh Kochar
Dilpreet Kaur
Money Sachdeva
author_facet Inderdeep Singh Kochar
Dilpreet Kaur
Money Sachdeva
author_sort Inderdeep Singh Kochar
collection DOAJ
description Abstract Background Iron deficiency anemia (IDA) remains one of the leading causes of childhood morbidity worldwide. Conventional therapy with ferrous sulfate is often limited by gastrointestinal (GI) side effects and poor adherence. Ferric pyrophosphate (FPP), a newer iron formulation, promises improved tolerance and equivalent efficacy. This study aimed to compare the efficacy and safety profile of FPP versus ferrous sulfate in the management of pediatric IDA. Methods A randomized controlled trial was conducted at a tertiary care center, enrolling 120 children aged 6 months to 12 years with IDA. Participants were randomly assigned to receive either FPP (1 mg/kg/day) or ferrous sulfate (3 mg/kg/day) for 6 months. Hemoglobin (Hb), serum ferritin, GI side effects, and compliance were assessed at baseline, 3 months, and 6 months. Results Both groups demonstrated a significant improvement in Hb levels, with the mean Hb rise being 3.1 g/dL in the FPP group and 3.3 g/dL in the FS group (p = 0.34). GI side effects were significantly lower in the FPP group (12%) compared to the FS group (41%) (p < 0.01). Compliance was also better in the FPP group (p < 0.001). Conclusion Ferric pyrophosphate is as effective as ferrous sulfate in correcting anemia and improving iron stores in children, with a significantly better tolerability profile. It presents a promising alternative to conventional iron therapy in pediatric IDA.
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spelling doaj-art-9736941c9dfb471b977e3e457d15abd42025-08-20T03:42:48ZengSpringerOpenEgyptian Pediatric Association Gazette2090-99422025-08-017311410.1186/s43054-025-00412-4Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trialInderdeep Singh Kochar0Dilpreet Kaur1Money Sachdeva2Department of Paediatrics, Dr. S.S. Tantia Medical College and Research CentreDepartment of Obstetrics and Gynaecology, Dr S.S. Tantia Medical College and Research CentreDepartment of Paediatrics, Dr. S.S. Tantia Medical College and Research CentreAbstract Background Iron deficiency anemia (IDA) remains one of the leading causes of childhood morbidity worldwide. Conventional therapy with ferrous sulfate is often limited by gastrointestinal (GI) side effects and poor adherence. Ferric pyrophosphate (FPP), a newer iron formulation, promises improved tolerance and equivalent efficacy. This study aimed to compare the efficacy and safety profile of FPP versus ferrous sulfate in the management of pediatric IDA. Methods A randomized controlled trial was conducted at a tertiary care center, enrolling 120 children aged 6 months to 12 years with IDA. Participants were randomly assigned to receive either FPP (1 mg/kg/day) or ferrous sulfate (3 mg/kg/day) for 6 months. Hemoglobin (Hb), serum ferritin, GI side effects, and compliance were assessed at baseline, 3 months, and 6 months. Results Both groups demonstrated a significant improvement in Hb levels, with the mean Hb rise being 3.1 g/dL in the FPP group and 3.3 g/dL in the FS group (p = 0.34). GI side effects were significantly lower in the FPP group (12%) compared to the FS group (41%) (p < 0.01). Compliance was also better in the FPP group (p < 0.001). Conclusion Ferric pyrophosphate is as effective as ferrous sulfate in correcting anemia and improving iron stores in children, with a significantly better tolerability profile. It presents a promising alternative to conventional iron therapy in pediatric IDA.https://doi.org/10.1186/s43054-025-00412-4Ferric pyrophosphateFerrous sulfatePediatric anemiaIron deficiencyGastrointestinal side effectsCompliance
spellingShingle Inderdeep Singh Kochar
Dilpreet Kaur
Money Sachdeva
Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
Egyptian Pediatric Association Gazette
Ferric pyrophosphate
Ferrous sulfate
Pediatric anemia
Iron deficiency
Gastrointestinal side effects
Compliance
title Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
title_full Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
title_fullStr Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
title_full_unstemmed Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
title_short Comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia: a 6-month randomized controlled trial
title_sort comparative efficacy and tolerability of ferric pyrophosphate vs ferrous sulfate in pediatric iron deficiency anemia a 6 month randomized controlled trial
topic Ferric pyrophosphate
Ferrous sulfate
Pediatric anemia
Iron deficiency
Gastrointestinal side effects
Compliance
url https://doi.org/10.1186/s43054-025-00412-4
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