Systematic computer analysis of iron fumarate pharmacology in the treatment of iron deficiency and iron deficiency anemia
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.632
Abstract
Introduction. The use of the safest and most effective methods for iron deficiency (ID) compensation is implicated in current therapy of iron deficiency anemia (IDA). Oral administration of iron salts with organic acid anions is an important field in IDA therapy and prevention. Iron fumarate, being a divalent iron salt and the fumaric acid anion (a tricarboxylic acid cycle metabolite), is absorbed in vivo via gene-encoded molecular mechanisms specialized to interact primarily with fumarate anion.
Aim: to systematize the data from fundamental and clinical studies on iron fumarate pharmacology for ID treatment using topological and metric methods of intellectual analysis.
Results. The results of systematization of studies on iron fumarate pharmacology (more than 500 articles) are presented along and performed categorization of all available publications. The results of the most essential research fields assessing iron fumarate pharmacology are described in detail: (1) comparative pharmacology of iron fumarate and other iron forms; (2) an effect of various iron salts on tissue hemosiderosis; (3) synergism between iron fumarate and folates and other micronutrients; (4) an effect of microbiome state and iron fumarate absorption improved by prebiotics; (5) clinical practice of using iron fumarate for IDA treatment of women in all age groups.
Conclusion. Fumarate-containing preparations are indicated in case where profound substrate-mediated support is required for pillar arms of aerobic and anaerobic energy metabolism ranging from mitochondria and cells to organismal level demanding to mobilize signal-regulatory adaptive reactions. Oral intake of fumarate salt preparations may exert milder and safer effect. In aerobic and hypoxic energy metabolism, which is typical for ID, fumarate salts may act as effective anti-stress and anti-hypoxic agents.
About the Authors
O. A. Gromova
Federal Research Center "Computer Science and Control", Russian Academy of Sciences
Russian Federation
Russian Federation
Olga A. Gromova, MD, Dr Sci Med, Prof.
Scopus Author ID: 7003589812
WoS ResearcherID: J-4946-2017
44 bldg. 2, Vavilova Str., Moscow 119333
I. Yu. Torshin
Federal Research Center "Computer Science and Control", Russian Academy of Sciences
Russian Federation
Russian Federation
Ivan Yu. Torshin, MD, PhD in Applied Mathematics, PhD in Chemistry
Scopus Author ID: 7003300274
WoS ResearcherID: C-7683-2018
44 bldg. 2, Vavilova Str., Moscow 119333
N. K. Tetruashvili
Academician Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Nana K. Tetruashvili, MD, Dr Sci Med, Prof.
4 Academician Oparin Str., Moscow 117997
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What is already known about this subject?
► Organic iron salts are of the lowest toxicity and hold top interest for prevention and treatment of iron deficiency anemia (IDA).
► Little information regarding organic iron salt pharmacokinetics and pharmacodynamics is available.
► There are fundamental and clinical data indicating about effectiveness and safety of iron fumarate administration.
What are the new findings?
► All available studies regarding iron fumarate have been categorized, additionally providing comparative pharmacology of fumarate and other iron forms, effects on hemosiderosis, synergism between iron fumarate and other micronutrients as well as microbiome along with clinical applications of iron fumarate in IDA treatment of pregnant women.
How might it impact on clinical practice in the foreseeable future?
► Iron fumarate vs. iron sulfate causes less damage to tooth enamel.
► Vitamin-mineral complex preparations containing iron fumarate are characterized by fewer side effects and better adherence to IDA therapy in postpartum women.
Review
For citations:
Gromova O.A., Torshin I.Yu., Tetruashvili N.K. Systematic computer analysis of iron fumarate pharmacology in the treatment of iron deficiency and iron deficiency anemia. Obstetrics, Gynecology and Reproduction. 2025;19(2):230-249. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2025.632
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