Dados do Trabalho

Título

Restless Legs Syndrome in Iron Deficiency Anemia - The Role of Intravenous Iron - Systematic Review

Introdução

Restless legs syndrome (RLS), otherwise known as Willis-Ekbom disease, is a sleep disorder marked by an irresistible need to move the legs, especially at night, associated with low serum and brain iron levels. In this sense, the prevalence of RLS is 6 times higher in individuals with iron deficiency anemia, in addition to presenting a more severe disorder, which affects 31.5% of anemic individuals compared to 5% of the general population.

Objetivo

To evaluate the efficacy of intravenous iron in the treatment of Restless Legs Syndrome in patients with Iron Deficiency Anemia (IDA).

Métodos

A systematic review was carried out in accordance with the PRISMA 2020 protocol. Inclusion criteria: studies that evaluated the efficacy of using intravenous ferric carboxymaltose in patients with RLS and anemia. Exclusion criteria: studies involving pregnant patients; end-stage renal disease; periodic limb movement

Resultados

Three hundred and nine articles were selected using the search strategy, six of which were included in this study, totaling a population of 217 patients. The main results found were: 1. Bae et al. randomized 29 patients with IDA to compare the therapeutic response when using Iron Carboxymaltose or Placebo in patients with RLS using the International Restless Legs Scale (IRLS). Patients in the intervention group had reduced symptoms of RLS compared to the placebo group (-13.47±7.38 versus +1.36±3.59; p<0.0001). 2. Short et al. compared intravenous and oral iron administration among 94 people. The authors found that both groups reduced the IRLS score by -7.9 ± 8.7 and -10.1 ± 10.4, respectively. 3. Mehmood et al. evaluated 42 patients with iron deficiency using the Cambridge-Hopkins Restless Legs Syndrome diagnostic questionnaire (CH-RLSq). Of these, 32 (76%) responded to intravenous (IV) iron treatment and 10 (24%) did not respond. The reduction in RLS symptoms in the group that responded to IV iron therapy was more significant than in the group that did not respond.

Conclusões

This systematic review showed the efficacy of intravenous iron in the treatment of Restless Legs Syndrome in patients with IDA. The results of the studies analyzed indicate a reduction in RLS symptoms after intravenous iron administration, compared to placebo or oral treatment. These findings reinforce the hypothesis that iron deficiency is an important causal factor in RLS and reinforce the relevance of iron supplementation as a first-line treatment for this condition.

Palavras -chave

Restless legs syndrome; intravenous iron; Anemia