PWE-049 Assessment of response and tolerance to oral iron supplements in patients with anaemia

Introduction Iron deficiency anaemia (IDA) is associated with “classical” signs and symptoms such as pallor and koilonychia. Tolerance to oral iron supplements is variable. Aim We recorded the classical signs and symptoms of iron deficiency in patients presenting to 2 week wait IDA clinic. We also assessed patients’ tolerance to oral iron supplements and subjective response. Patients and methods Patients referred to our iron deficiency clinic were assessed for symptoms and signs of iron deficiency using a proforma. All patients were started on oral ferrous sulphate 200 mg twice daily. Clinical response and tolerability were assessed at 1 and 3 months. Results There were 336 patients with iron deficiency anaemia and 58 patients with other types of anaemia, mainly anaemia of chronic disease. There were no differences in baseline characteristics between the two groups. In patients with IDA, the most frequent symptoms of iron deficiency were pallor (42.9%), hair loss (16.4%), less commonly ridges (3.0%), glossitis (1.5%), koilonychia (0.9%) or cheilosis (0.6%). Patients responded to iron supplements and reported reduction in fatigue. Most frequently reported side effects related to oral iron supplements were black stools (66.8%), diarrhoea (20.0%), constipation (20.6%), pruritus (20.0%), abdominal discomfort (20.0%) and nausea (11.1%). 11.1% patients with IDA required dose adjustment or intravenous supplements. Interestingly, patients in the group of “other” types of anaemia presented symptoms of iron deficiency. Side effects or oral iron supplements were also similar. (See table 1 below for detail.) 15.5% of patients required dose reduction or intravenous supplements. However, here was only little response in blood test results although subjective fatigue score improved. Conclusion Iron supplements are well tolerated in patients with anaemia. Their use in patients with no evidence of iron deficiency however is of modest clinical benefit.