title: A randomized controlled trial of oral heme iron polypeptide versus oral iron supplementation for the treatment of anaemia in peritoneal dialysis patients: HEMATOCRIT trial. Treatment of anaemia after joint replacement. A double-blind, randomised, controlled trial of ferrous sulphate versus placebo. Association of anaemia in primary care patients with chronic kidney disease: cross sectional study of quality improvement in chronic kidney disease (QICKD) trial data Heme iron polypeptide for the treatment of iron deficiency anemia in non-dialysis chronic kidney disease patients: a randomized controlled trial A randomized, controlled trial comparing IV iron sucrose to oral iron in anemic patients with nondialysis-dependent CKD. Iron pre-load for major joint replacement. Efficacy and tolerability of oral iron therapy in inflammatory bowel disease: a prospective, comparative trial Oral iron therapy for anaemia after orthopaedic surgery: randomized clinical trial IRON-HF study: a randomized trial to assess the effects of iron in heart failure patients with anemia. Iron, folate and vitamins B12 & C dietary intake of an elderly institutionalized population in León, Spain. Iron supplementation for anemia after hip fracture surgery: a randomized trial of 300 patients. Treatment of mild non-chemotherapy-induced iron deficiency anemia in cancer patients: comparison between oral ferrous bisglycinate chelate and ferrous sulfate. Intravenous iron sucrose is superior to oral iron sulphate for correcting anaemia and restoring iron stores in IBD patients: A randomized, controlled, evaluator-blind, multicentre study Short course pre-operative ferrous sulphate supplementation--is it worthwhile in patients with colorectal cancer? Iron supplementation after femoral head replacement for patients with normal iron stores. Are we giving too much iron? Low-dose iron therapy is effective in octogenarians. Post-operative anaemia in femoral neck fracture patients: does it need treatment? A single blinded prospective randomised controlled trial.
abstract: BACKGROUND Preliminary clinical evidence suggests that heme iron polypeptide ( HIP ) might represent a promising , novel oral iron supplementation strategy in chronic kidney disease . The aim of this multi-centre r and omized controlled trial was to determine the ability of HIP administration to augment iron stores in darbepoetin (DPO)-treated patients compared with conventional oral iron supplementation . METHODS Adult peritoneal dialysis ( PD ) patients treated with DPO were r and omized 1:1 to receive two capsules daily of either HIP or ferrous sulphate per os for 6 months . The primary outcome measure was transferrin saturation ( TSAT ) . Secondary outcomes comprised serum ferritin , haemoglobin , DPO dose and responsiveness , and adverse events . RESULTS Sixty-two patients were r and omized to HIP ( n = 32 ) or ferrous sulphate ( n = 30 ) . On intention-to-treat analysis , the median ( inter-quartile range ) TSAT was 22 % ( 16 - 29 ) in the HIP group compared with 20 % ( 17 - 26 ) in controls ( P = 0.65 ) . HIP treatment was not significantly associated with TSAT at 6 months on multivariable analysis ( P = 0.95 ) . Similar results were found on per- protocol analysis and subgroup analysis in iron-deficient patients . Serum ferritin levels at 6 months were significantly lower in the HIP group ( P = 0.003 ) , while the cost of HIP was 7-fold higher than that of ferrous sulphate . No other differences in secondary outcomes were observed . CONCLUSIONS HIP showed no clear safety or efficacy benefit in PD patients compared with conventional oral iron supplements . The reduction in serum ferritin levels and high costs associated with HIP therapy suggest that this agent is unlikely to have a significant role in iron supplementation in PD patients After total hip and knee replacement arthroplasty , patients may become anaemic and may be prescribed oral iron . There is , however , no published evidence that this is of benefit when used postoperatively . We treated 72 patients who were anaemic after primary total hip and knee arthroplasty by r and omly allocating them to receive six weeks of either oral ferrous sulphate ( 35 patients ) or a placebo ( 37 patients ) . Both groups of patients were similar in all aspects except for the treatment given . There was no statistically significant difference in the change of haemoglobin levels between the two groups . We therefore believe that the prescription of iron to all anaemic patients post-operatively should be avoided . The level of serum ferritin should be monitored at preoperative assessment Background Anaemia is a known risk factor for cardiovascular disease and treating anaemia in chronic kidney disease ( CKD ) may improve outcomes . However , little is known about the scope to improve primary care management of anaemia in CKD . Methods An observational study ( N = 1,099,292 ) with a nationally representative sample using anonymised routine primary care data from 127 Quality Improvement in CKD trial practice s ( IS RCT N5631023731 ) . We explored variables associated with anaemia in CKD : eGFR , haemoglobin ( Hb ) , mean corpuscular volume ( MCV ) , iron status , cardiovascular comorbidities , and use of therapy which associated with gastrointestinal bleeding , oral iron and deprivation score . We developed a linear regression model to identify variables amenable to improved primary care management . Results The prevalence of Stage 3–5 CKD was 6.76 % . Hb was lower in CKD ( 13.2 g/dl ) than without ( 13.7 g/dl ) . 22.2 % of people with CKD had World Health Organization defined anaemia ; 8.6 % had Hb ≤ 11 g/dl ; 3 % Hb ≤ 10 g/dl ; and 1 % Hb ≤ 9 g/dl . Normocytic anaemia was present in 80.5 % with Hb ≤ 11 ; 72.7 % with Hb ≤ 10 g/dl ; and 67.6 % with Hb ≤ 9 g/dl ; microcytic anaemia in 13.4 % with Hb ≤ 11 g/dl ; 20.8 % with Hb ≤ 10 g/dl ; and 24.9 % where Hb ≤ 9 g/dl . 82.7 % of people with microcytic and 58.8 % with normocytic anaemia ( Hb ≤ 11 g/dl ) had a low ferritin ( < 100ug/mL ) . Hypertension ( 67.2 % vs. 54 % ) and diabetes ( 30.7 % vs. 15.4 % ) were more prevalent in CKD and anaemia ; 61 % had been prescribed aspirin ; 73 % non-steroidal anti-inflammatory drugs ( NSAIDs ) ; 14.1 % warfarin 12.4 % clopidogrel ; and 53.1 % aspirin and NSAID . 56.3 % of people with CKD and anaemia had been prescribed oral iron . The main limitations of the study are that routine data are inevitably incomplete and definitions of anaemia have not been st and ardised . Conclusions Medication review is needed in people with CKD and anaemia prior to considering erythropoietin or parenteral iron . Iron stores may be depleted in over > 60 % of people with normocytic anaemia . Prescribing oral iron has not corrected anaemia Background Anemia secondary to iron deficiency is common in patients with non-dialysis dependent chronic kidney disease ( ND-CKD ) but it is unclear if oral supplementation is as effective as intravenous ( IV ) supplementation in re-establishing iron stores . The purpose of this study was to determine if oral Heme Iron Polypeptide ( HIP ) is as effective as IV iron sucrose in the treatment of iron-deficiency anemia for patients with ND-CKD . Methods Forty ND-CKD patients were r and omized ; 18 to HIP  11 mg orally 3 times per day and 22 to IV iron sucrose 200 mg monthly for 6 months . Baseline clinical and laboratory data were collected for all patients . The primary and secondary outcomes for the study were hemoglobin ( Hgb ) concentration and iron indices [ ferritin and percentage transferrin saturation ( TSAT ) ] at the end of 6 months respectively . Adverse events were also compared . Results The baseline demographic characteristics and laboratory values were similar for the two groups . After 6 months of treatment , Hb in the  HIP  group was 117 g/L and 113 g/L in the IV sucrose group ( p = 0.37 ) . The TSAT at 6 months was not different between the two groups { p = 0.82}but the serum ferritin was significantly higher in the IV iron sucrose group { 85.5 ug/L in HIP and 244 ug/L ; p = 0.004}. Overall adverse events were not different between the groups . Conclusion HIP is similar in efficacy to IV iron sucrose in maintaining hemoglobin in ND-CKD patients with no differences in adverse events over 6 months . It is unclear if the greater ferritin values in the IV iron sucrose group are clinical ly significant . Trial registration Clinical Trials.gov : BACKGROUND Although iron deficiency frequently complicates anemia in patients with nondialysis-dependent CKD ( ND-CKD ) , the comparative treatment value of IV iron infusion and oral iron supplementation has not been established . METHODS In a r and omized , controlled multicenter trial , we compared the efficacy of iron sucrose , given as 1 g in divided IV doses over 14 days , with that of ferrous sulfate , given 325 mg orally thrice daily for 56 days in patients with ND-CKD stages 3 to 5 , Hb < or = 11 g/dL , TSAT < or = 25 % , and ferritin < or = 300 ng/mL.  Epoetin/darbepoetin therapy , if any , was not changed for eight weeks prior to or during the study . RESULTS The proportion of patients achieving the primary outcome ( Hb increase > or = 1 g/dL ) was greater in the IV iron treatment group than in the oral iron treatment group ( 44.3 % vs. 28.0 % , P= 0.0344 ) , as was the mean increase in Hb by day 42 ( 0.7 vs. 0.4 g/dL , P= 0.0298 ) . Compared to those in the IV iron group , patients in the oral iron treatment group showed a greater decline in GFR during the study ( -4.40 vs. -1.45 mL/min/1.73m2 , P= 0.0100 ) . No serious adverse drug events ( ADE ) were seen in patients administered IV iron sucrose as 200 mg IV over two to five minutes , but drug-related hypotension , including one event considered serious , occurred in two females weighing less than 65 kg after 500 mg doses were given over four hours . CONCLUSION IV iron administration using 1000 mg iron sucrose in divided doses is superior to oral iron therapy in the management of ND-CKD patients with anemia and low iron indices Patients undergoing total hip or knee replacement frequently receive  blood transfusion . Homologous blood transfusion carries appreciable risks and should therefore be reduced to a minimum . We have investigated the use of preoperative oral iron supplements to optimize haemoglobin concentration and iron stores prior to surgery . All patients attending a preadmission clinic 4 weeks prior to primary hip or knee replacement had a haemoglobin measurement .  If the haemoglobin concentration ( Hb ) was less than 12 g dL-1 they were given a four week course of ferrous sulphate . If it was greater than or equal to 12 g dL-1 they were r and omized to a control group or given a supplementation course of ferrous sulphate .  One hundred patients were seen . Of these 18 ( 18 % ) had haemoglobin less than 12 g dL-1 and 16 were treated with iron . The mean Hb was 10.8 g dL-1 and mean cell volume ( MCV ) 86 . These patients increased their Hb by a mean 1.1 g dL-1 prior to admission ( P = 0.008 ) . MCV was the best predictor of response ( r = -0.63 , P < 0.02 ) . This group dropped their haemoglobin by a mean 1.4 g dL-1 in the first post-operative week . In the study groups there was no significant preoperative rise in Hb . However , the control group dropped their Hb by a mean 1.3 g dL-1 in the week following surgery compared with 0.4 g dL-1 in the group which had received iron supplements ( P < 0.001 ) . We conclude that at least 18 % of patients attending for hip or knee replacement in this region are frankly anaemic and benefit significantly from preoperative iron supplements over 4 weeks . Iron supplementation in patients without obvious anaemia protects against a fall in Hb during the immediate post-operative period , suggesting a widespread underlying depletion of iron stores in this group despite a normal Hb . Preoperative iron supplements may reduce transfusion requirements as part of a co-ordinated strategy in this group of patients Background : In patients with inflammatory bowel disease , oral iron is anecdotally reported to be less effective and less well tolerated than in those without inflammatory bowel disease , and to increase disease activity Background : Oral iron therapy is often used after orthopaedic surgery to improve haemoglobin levels . The aim of the present trial was to determine if administration of oral iron  after orthopaedic surgery results in a better improvement of haemoglobin levels than a control treatment BACKGROUND Anemia in heart failure patients and has been associated with increased morbi-mortality . Previous studies have treated anemia in heart failure patients with either erythropoietin alone or combination of erythropoietin and intravenous ( i.v . ) iron . However , the effect of i.v . or oral ( p.o . ) iron supplementation alone in heart failure patients with anemia was virtually unknown . AIM To compare , in a double-blind design , the effects of i.v . iron versus p.o . iron in anemic heart failure patients . METHODS IRON-HF study was a multicenter , investigator initiated , r and omized , double-blind , placebo controlled trial that enrolled anemic heart failure patients with preserved renal function , low transferrin saturation ( TSat ) and low-to-moderately elevated ferritin levels . Interventions were Iron Sucrose i.v . 200 mg , once a week , for 5 weeks , ferrous sulfate 200 mg p.o . TID , for 8 weeks , or placebo . Primary endpoint was variation of peak oxygen consumption ( peak VO2 ) assessed by ergospirometry over 3 month follow-up . RESULTS Eighteen patients had full follow-up data . There was an increment of 3.5 ml/kg/min in peak VO2 in the i.v . iron group . There was no increment in peak VO2 in the p.o . iron group . Patients ' ferritin and TSat increased significantly in both treated groups . Hemoglobin increased similarly in all groups . CONCLUSION I.v . iron seems to be superior in improving functional capacity  of heart failure patients . However , correction of anemia seems to be at least similar between p.o . iron and i.v . iron supplementation Aging is associated with increased risk of developing anaemia and micronutrient deficiencies . The purpose of this study was to evaluate the daily intake of micronutrient whose deficient in diet could cause anaemia ( iron , folic acid , vitamin B12 ) and vitamin C to establish the prevalence of anaemia in a group of institutionalized of 124 elderly subjects residing in five nursing homes in León ( Spain ) . A precise weighing method was used to conduct the control of food intake covering seven days . Energy , alcohol , iron , folate , vitamin B12 , and vitamin C intake were obtained . Weight , and Height also were measured . Serum iron , serum ferritin , haemoglobin and hematocrit were also measured . Average daily iron intake was higher than the 10 mg recommended by the National Academy of Science although significantly higher ( p < 0.05 ) in males ( 17.0 + /- 7.4 mg ) than in females ( 11.8 + /- 1.5 mg ) . Moreover , vitamin C intake in all subjects is high ( 118.8 + /- 43.7 mg ) and higher than Spanish RDA ( 198 % ) . Average intakes of folate and vitamin B12  in the present study exceeded the RDA , ( 103 % and 144 % ) . However , 45.83 % of males and 5.97 % of females showed deficiencies in vitamin B12 and 53.91 % of the subjects showed deficiencies in folic acid . The average haemoglobin concentration ( 14.28 + /- 1.33 g/dL ) , hematocrit percentage ( 43.71 + /- 6.31 ) , ferritin concentration ( 87.01 + /- 59.74 ng/mL ) and serum iron ( 85.36 + /- 33.98 micrograms/dL ) showed similar figures to the results obtained in other studies carried out on elderly population s. It would be necessary to adequately compose the menus given in nursing homes , decreasing energy contribution , and supplying micronutrient rich foods or fortified foods BACKGROUND Anemia as a consequence of surgery is often treated with iron therapy . The evidence base for this practice is limited . To determine if oral iron therapy is beneficial for the treatment of anemia after surgery for the treatment of a hip fracture , we undertook a prospect i ve , r and omized controlled trial . METHODS Three hundred patients with a hemoglobin level of < 110 g/L after treatment for a hip fracture were r and omized to receive either a twenty-eight-day course of ferrous sulfate therapy or no iron therapy .  Hemoglobin levels were measured at six weeks after surgery . The length of the hospital stay and the mortality rate at one year were compared between groups . RESULTS The mean rise in hemoglobin levels six weeks after discharge from the hospital was 21 g/L in the iron group , compared with 18 g/L in the no-iron group ( p = 0.07 ) . There was no significant difference between the two groups with regard to the length of hospital stay or the mortality rate . Seventeen percent of the patients who were allocated to iron therapy reported adverse effects of the medication . CONCLUSIONS The present study demonstrated that iron therapy had no clinical ly relevant benefit when used to treat anemia associated with a hip fracture In cancer patients mild-moderate non-chemotherapy-induced iron deficiency anemia ( IDA ) is usually treated with oral iron salts , mostly ferrous sulfate . In this study , we compare efficacy and toxicity of oral ferrous bisglycinate chelate and ferrous sulfate in cancer patients with mild IDA . Twenty-four patients operated on for solid tumors ( 10 breast , 12 colorectal , 2 gastric ) , aged 61±10 years ( range 45 - 75 ) , with non-chemotherapy-induced hemoglobin ( Hb ) values between 10 and 12 g/dL and ferritin lower than 30 ng/mL were r and omized to receive oral ferrous bisglycinate chelate , 28 mg per day for 20 days , and then 14 mg per day for 40 days ( 12 patients ) ( A group ) or oral ferrous sulphate , 105 mg per day for 60 days ( 12 patients ) ( B group ) . Values of hemoglobin and ferritin obtained at diagnosis , 1 and 2 months from the beginning of treatment were compared . Adverse events ( AEs ) related to the two treatments were recorded . In the 12 patients treated with ferrous bisglycinate chelate  , basal hemoglobin and ferritin values ( mean±SD ) were 11.6±0.8 g/dL and 16.1±8.0 ng/mL. After 2 months of treatment , they were 13.0±1.4 g/dL and 33.8±22.0 ng/mL , respectively ( P=0.0003 and P=0.020 ) . In the group treated with ferrous sulphate , hemoglobin and ferritin mean values were 11.3±0.6 g/dL and 19.0±6.4 ng/mL basally , and 12.7±0.70 g/dL and 40.8±28.1 ng/mL ( P<0.0001 and P=0.017 ) after 2 months of treatment . AEs occurred in six cases . In all these six cases , two ( 17 % ) treated with ferrous bisglycinate chelate and four ( 33 % ) with ferrous sulphate , toxicity was grade 1 . In conclusion , these data suggest that ferrous bisglycinate chelate has similar efficacy and likely lower GI toxicity than ferrous sulphate given at the conventional dose of 105 mg per day for the same time Objective . Patients with inflammatory bowel disease ( IBD ) often have low iron stores or anaemia . There is controversy about whether iron should be supplemented orally or intravenously ( i.v . ) . The purpose of this study was to investigate whether treatment with intravenous iron is superior to treatment with oral iron . The primary end-points were response and remaining anaemia at the end of treatment ( EOT ) . Material and methods . Ninety-one patients with IBD and anaemia ( B-Hb < 115 g/L ) were r and omized to oral iron sulphate ( n=46 ) or intravenous iron sucrose ( n=45 ) treatment for 20 weeks . Results . Forty-three patients in the intravenous iron group completed the study compared to 35 patients in the oral iron group ( p=0.0009 ) . Only 22 patients ( 48 % ) tolerated the prescribed oral dose , and 52 % reduced the dose or withdrew from treatment because of poor tolerance . At EOT , 47 % patients in the oral iron group increased their B-Hb by ≥20 g/L , compared with 66 % in the intravenous iron group ( p=0.07 ) . In the oral iron group , 41 % still had anaemia versus 16 % of the patients in the intravenous iron group ( p=0.007 ) , and 22 % versus 42 % reached their reference B-Hb level ( p=0.04 ) . Treatment with intravenous iron sucrose improved iron stores faster and more effectively than oral iron ( p=0.002 ) . Under treatment with intravenous iron , 74 % of the patients had no anaemia and normal S-ferritin levels ( > 25 µg/L ) at EOT compared with 48 % of patients receiving oral iron ( p=0.013 ) . Conclusions . Treatment with intravenous iron sucrose is effective , safe , well tolerated and superior to oral iron in correcting haemoglobin and iron stores in patients with IBD INTRODUCTION Pre-operative anaemia is well recognised in patients presenting with colorectal cancer ( CRC ) . While the benefits of long-term FeSO4 supplementation on Fe deficiency anaemia are well established , it is not known if short-course supplementation ( 2 - 3 weeks ) impacts significantly on pre-operative haemoglobin ( Hb ) levels . This study examines the impact of short-term , oral FeSO4 supplementation on patients undergoing surgery for CRC . PATIENTS AND METHODS All patients with CRC presenting to a single surgeon were included . At diagnosis , baseline  Hb  and  blood film  were checked on all patients who then received 200 mg tds of FeSO4 . Haemoglobin was rechecked pre-operatively and daily postoperatively . Patients requiring pre-operative blood transfusions were excluded from analysis . RESULTS Between 1 January 2004 and 31 December 2006 , 117 patients were identified , 14 of whom were excluded . Patients received a median of 39 days ' treatment with FeSO4 . Fifty-eight ( 56.3 % ) patients were anaemic at presentation gaining a mean of 1.73 g/dl ( P<0.001 ) from short-course FeSO4 supplementation . Right-sided tumours ( lower mean Hb at presentation ; P=0.008 ) responded more to FeSO4 when compared to left-sided tumours ( P<0.017 ) . Increase in Hb was unrelated to pathological stage . The transfusion rate for all curative resections was 0.69 units/patient . For the historical cohort ( patients undergoing curative resection between 1 January 2001 and 31 December 2003 ) , the mean transfusion rate fell from 1.69 units/patient . CONCLUSIONS Routine short-course supplementation with iron offers improved pre-operative Hb prior to surgery in CRC , especially in right-sided lesions and those with presenting anaemia OBJECTIVE To assess the efficacy of oral iron therapy in the recovery of patients ' hemoglobin levels after major surgery . DESIGN R and omized controlled trial . SETTING Private orthopedic practice confined to one large community hospital . PATIENTS One hundred seventy consecutive elderly patients undergoing hip surgery ; 75 failed to meet entry hematologic or medical criteria ; 95 were r and omized , with 16 withdrawn because of complications . INTERVENTION Thirty-seven patients received ferrous sulfate orally four times a day for the duration of their hospitalization . Forty-two patients who received no iron supplement served as the control group . MAIN OUTCOME MEASURES Changes in hemoglobin levels and reticulocyte counts over the 2- to 3-week follow-up period . RESULTS There was no significant difference in mean hemoglobin levels between the treatment and control groups ( 95 % confidence interval [ CI ] for difference of -6.6 to 5.4 g/L ) . Corrected reticulocyte fractions increased equally in both groups ( 95 % CI for difference of -9 x 10(3 ) to 2 x 10(-3 ) . The study was design ed to detect a difference in mean hemoglobin levels of 8.5 g/L or greater or a difference in mean reticulocyte fraction of 10 x 10(-3 ) between the two groups with a power of 0.80 at the .05 ( two-sided ) level of significance . CONCLUSION The administration of oral iron supplements to elderly , healthy orthopedic patients postoperatively did not hasten the recovery of hemoglobin levels , provided adequate tissue iron stores were present PURPOSE Elderly patients are vulnerable to the dose-dependent adverse effects of iron replacement therapy . Our study examines whether low-dose iron therapy can efficiently resolve iron-deficiency anemia in patients over the age of 80 years and reduce adverse effects . SUBJECTS AND METHODS Ninety hospitalized patients with iron-deficiency anemia were r and omized to receive elemental iron in daily doses of 15 mg or 50 mg as liquid ferrous gluconate or 150 mg of ferrous calcium citrate tablets for 60 days . Thirty control patients without anemia were given 15 mg of iron for 60 days . A 2-hour iron absorption test was performed after the initial dose . Hemoglobin and ferritin levels were measured on day 1 , 30 , and 60 after initiating therapy . Each patient completed a weekly question naire regarding drug-induced adverse effects . RESULTS Serum iron rose significantly in the anemic patients beginning 15 minutes after the first dose but not in nonanemic patients . Two months of iron treatment significantly increased hemoglobin and ferritin concentrations similarly in all 3 groups of iron-deficiency anemia patients ( for example , hemoglobin levels rose from 10.0 g/dL to 11.3 g/dL with 15 mg/d of iron therapy and from 10.2 g/dL to 11.6 g/dL with 150 mg/d ) . Abdominal discomfort , nausea , vomiting , changes in bowel movements , and black stools were significantly more common at higher iron doses . CONCLUSIONS Low-dose iron treatment is effective in elderly patients with iron-deficiency anemia . It can replace the commonly used higher doses and can significantly reduce adverse effects A prospect i ve r and omised controlled trial was performed to establish the effect of oral iron supplementation on haemoglobin level at 4 weeks post-operative in elderly patients with fractured neck of femur undergoing surgical treatment . We single blindly r and omised 68 patients into two groups . Thirty-four patients in the treatment group were compared with 32 in the control group . The treatment group received 200 mg of oral iron tablets 3 times a day for 4 weeks in the post-operative period compared to nothing for the control group . The groups were comparable in all other aspects . The iron treatment result ed in significantly increased haemoglobin value at 4 weeks ; 0.76 g% higher than the control group ( 95 % CI of + 0.01 to + 1.51 ) which is statistically significant ( P<0.05 ) . There was no major complication . We recommend oral iron supplementation in elderly anaemic patients with hip fracture in the post-operative period
target: There were no statistically significant differences in adverse effects , length of hospitalisation or mortality .
  Conclusion Oral iron raises haemoglobin levels in elderly people with iron deficiency anaemia by 0.35 g/dL after 4–6 weeks , but it is unclear if this results in tangible health benefits
background: Background Oral iron supplementation is used widely in older people despite observational studies suggesting it is ineffective .
  Objective The aim of this systematic review was to determine if oral iron therapy is effective in elderly people with iron deficiency anaemia .