Rapid increase in intravenous iron therapy for women of reproductive age in Australia

Antonia W Shand and Natasha Nassar
Med J Aust 2021; 214 (6): . || doi: 10.5694/mja2.50979
Published online: 5 April 2021

In reply: We agree with Jayasuriya and colleagues that iron deficiency anaemia may be undertreated. Intravenous iron is recommended when rapid restoration of haemoglobin and iron stores is required, oral iron cannot be tolerated, or poor absorption is expected. The National Patient Blood Management Collaborative aims to prevent transfusion and its complications by optimising haemoglobin and iron stores.1 However, randomised trials do not show evidence for benefit of intravenous iron on all outcomes in all populations, including the need for blood transfusion. A recent large randomised trial found no evidence for benefit in giving intravenous iron preoperatively to patients with anaemia undergoing major abdominal surgery.2

  • 1 Children’s Hospital at Westmead, University of Sydney, Sydney, NSW
  • 2 Royal Hospital for Women, Sydney, NSW
  • 3 Menzies Centre for Health Policy, University of Sydney, Sydney, NSW

Competing interests:

No relevant disclosures.

  • 1. Australian Commission on Safety and Quality in Health Care. The National Patient Blood Management Collaborative [website]. (viewed Feb 2021).
  • 2. Richards T, Baikady RR, Clevenger B, et al. Preoperative intravenous iron to treat anaemia before major abdominal surgery (PREVENTT): a randomised, double‐blind, controlled trial. Lancet 2020; 10259: 1353–1361.
  • 3. DeLoughery TG. Safety of oral and intravenous iron. Acta Haematol 2019; 142: 8–12.
  • 4. Miles LF, Litton E, Imberger G, Story D. Intravenous iron therapy for non‐anaemic, iron‐deficient adults. Cochrane Database Syst Rev 2019; (12): CD013084.
  • 5. Choosing Wisely Australia. What is Choosing Wisely Australia? [Website] (viewed Feb 2021).


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