Iron for the treatment of restless legs syndrome
Trotti LM, Becker LA
Published in Cochrane Database of Systematic Reviews
Methodology
Cochrane systematic review searching CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL from January 1995 to September 2017 plus trial registries; controlled trials of any iron formulation versus placebo, other medication or no treatment in adults with restless legs syndrome; random-effects meta-analysis with mean and standardised mean differences, Mantel-Haenszel risk ratios and GRADE assessment.
Key Findings
This Cochrane review included 10 controlled trials with 428 participants followed for 2 to 16 weeks, nine comparing iron with placebo and one with pramipexole. Pooling seven trials using the International Restless Legs Scale, iron improved symptoms more than placebo (mean difference -3.78 points, 95% CI -6.25 to -1.31; I-squared 66%, 345 participants), with GRADE certainty rated moderate. Iron improved quality of life on continuous scales but made no difference to subjective or objective sleep quality, periodic limb movements or Epworth sleepiness, and did not cause significantly more adverse events than placebo (RR 1.48, 95% CI 0.97 to 2.25). Iron and pramipexole produced similar symptom reduction in the single head-to-head trial (30 participants).
Conclusions
Iron therapy probably improves restlessness and RLS severity versus placebo.
Limitations
Substantial heterogeneity between trials (I-squared 66-80%), all studies had at least one domain at unclear risk of bias and three had a high-risk domain; secondary outcomes were graded low to very low certainty, and optimal dose, route and timing remain unknown.
Supplements Studied
Iron therapy probably improves restlessness and RLS severity in comparison to placebo.
Related Health Concerns
Study Details
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