Safety of oral iron supplements for iron deficiency anemia in children: a network meta-analysis

Objective To compare and evaluate the safety of eight kinds of oral iron supplements that treat children with iron deficiency anemia(IDA) by using Network Meta-analysis. Methods We searched and collected domestic and foreign literatures on oral iron supplement for iron deficiency anemia children in CNKI, PubMed, Cochrane Library and Science Direct Database from the inception to July 2015. Statistical analysis was performed by Microsoft Excel 2013 software, we used the NetMetaXL macros in it to load the WinBUGS 1.4.3 software to conduct the calculate by random effects Bayesian models. The odds ratios (ORs) and mean ranking and the probability among eight kinds of oral irons were estimated. Results We identified 31 eligible studies which involved 3 417 children with IDA. In network analyses, there was higher risk that ferrous sulfate(OR=0.00, 95% CI:0.00-0.03), sodium iron chlorophyll (OR=0.03, 95% CI:0.00-0.39), ferrous succinate (OR=0.02, 95% CI:0.00-0.23), ferrous gluconate(OR=0.01, 95% CI: 0.00-0.07), multidimensional iron compounds(OR=0.01 95% CI:0.00-0.11), iron polymaltose complex(OR=0.02, 95% CI:0.00-0.19) and ferrous fumarate (OR=0.01, 95% CI:0.00-0.12) prevented side-effects when compared to iron dextran. Although iron dextran was ranked the regiment with the least favorable adverse event profile among eight kinds of oral irons (SUCRA=0.999 4), ferrous sulfate was the highest risk (SUCRA=0.034 1). Conclusions Our results suggest that consumers and clinicians might be more cautious when using ferrous sulfate to treat children with IDA, because of its highest risk among other oral iron supplements.