120 Participants Needed

Iron Replacement Therapy for Iron-Deficiency Anemia

(IDA Trial)

Recruiting at 3 trial locations
SS
Overseen BySilvie Suriany, MSc
Age: < 65
Sex: Female
Trial Phase: Phase 4
Sponsor: Children's Hospital Los Angeles
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how iron deficiency anemia (IDA) affects the brain and whether iron replacement can enhance brain function and blood flow in adult women with moderate to severe anemia. It will assess two treatments: standard oral iron supplements (ferrous sulfate) and an intravenous iron infusion (ferric carboxymaltose) followed by a daily iron pill. Women who have struggled with anemia and experience symptoms like fatigue might be suitable for the interventional arm. Those with normal iron levels can join as healthy controls for the observational part.

As a Phase 4 trial, the treatment is already FDA-approved and proven effective, aiming to understand how it benefits more patients.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes people who need medication for diabetes or hypertension. It's best to discuss your specific medications with the trial team.

What is the safety track record for Ferric carboxymaltose and Ferrous sulfate?

Research shows that ferric carboxymaltose, one of the treatments under study, is generally safe and well-tolerated. Studies have found that it effectively raises hemoglobin levels with only a few minor side effects. Most patients experienced minimal adverse reactions. Ferrous sulfate, another treatment, is a common and FDA-approved option for iron deficiency anemia. It is generally safe, though some people might experience mild digestive issues like stomach upset or constipation. Overall, these treatments have undergone sufficient testing to demonstrate their safety for most people.12345

Why are researchers enthusiastic about this study treatment?

Unlike traditional oral iron supplements like ferrous sulfate, which can take weeks to improve symptoms of iron-deficiency anemia and sometimes cause digestive side effects, ferric carboxymaltose offers a different approach. Researchers are excited about ferric carboxymaltose because it's administered intravenously, allowing for a higher dosage to be delivered directly into the bloodstream, which can replenish iron stores more rapidly. This method potentially leads to quicker symptom relief and is especially beneficial for those who can't tolerate or absorb oral iron well.

What evidence suggests that this trial's treatments could be effective for iron-deficiency anemia?

Research has shown that ferric carboxymaltose, which participants in this trial may receive as part of the intravenous (IV) iron treatment arm, effectively treats iron-deficiency anemia (IDA). Studies have found that it improves hemoglobin and ferritin levels, which are crucial for oxygen transport in the blood. In one study, a single dose of ferric carboxymaltose was safe and often outperformed other iron treatments. Another study found it more effective than iron pills, particularly in correcting anemia and iron deficiency. This treatment has successfully managed IDA in various patient groups, demonstrating its effectiveness.678910

Who Is on the Research Team?

JW

John Wood, MD,PhD

Principal Investigator

Children's Hospital Los Angeles

Are You a Good Fit for This Trial?

This trial is for adult women aged 18-60 with moderate to severe iron deficiency anemia (IDA). Participants must have specific lab results indicating IDA and a hemoglobin level ≤10.5 g/dl or hematocrit <32%. Exclusions include MRI contraindications, systemic inflammatory diseases, severe asthma, eczema, atopy, diabetes on medication, hypertension on medication, prior reaction to IV iron, severe respiratory/cardiac disease or morbid obesity.

Inclusion Criteria

In the observational group, the control group should have hemoglobin levels above 13.2 g/dl or hematocrit levels above 39.6%.
My blood tests show I have low hemoglobin or hematocrit levels.
I have iron deficiency anemia as diagnosed by a hematologist.
See 2 more

Exclusion Criteria

I had a reaction to intravenous iron in the past.
I am taking medication for high blood pressure.
I have severe heart or lung disease.
See 10 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Observation

Comprehensive cerebrovascular MRI, bloodwork, patient-reported outcomes, and neurocognitive testing are collected from all subjects in the observational arm.

Baseline (Day 0)
1 visit (in-person)

Intervention

Eligible anemic subjects receive either intravenous iron therapy or standard oral iron therapy. Repeated tests are conducted to assess the effects and durability of iron therapy.

12 months
Multiple visits (in-person and virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at various time points including Day 14, Day 90, Day 180, and Day 365 post iron therapy.

12 months
Multiple visits (in-person and virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Ferric carboxymaltose
  • Ferrous sulfate
Trial Overview The study aims to understand the impact of IDA on brain function and structure in women and test if these effects can be reversed by iron replacement therapy. It involves two treatments: NovaFerrum and Ferric derisomaltose. The trial has both observational (examining existing conditions) and interventional (testing new treatments) components.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: Intravenous (IV) ironExperimental Treatment2 Interventions
Group II: Standard of care ironActive Control1 Intervention
Group III: Healthy ControlsActive Control1 Intervention

Ferric carboxymaltose is already approved in European Union, Canada, United States for the following indications:

🇪🇺
Approved in European Union as Ferinject for:
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Approved in Canada as Ferinject for:
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Approved in United States as Ferinject for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Children's Hospital Los Angeles

Lead Sponsor

Trials
257
Recruited
5,075,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials
1,403
Recruited
655,000+

Published Research Related to This Trial

In a study of 264 geriatric patients (average age 76.9 years), intravenous ferric carboxymaltose significantly improved hemoglobin levels, serum ferritin, and transferrin saturation, indicating its efficacy in treating functional iron deficiency anemia.
The treatment was well tolerated with no severe adverse reactions reported, making ferric carboxymaltose a safe and effective option for elderly patients with anemia related to chronic conditions.
[Efficacy and tolerability of ferric carboxymaltose in geriatric patients with anemia. Data from three non-interventional studies].Röhrig, G., Steinmetz, T., Stein, J., et al.[2022]
In a study involving 40 patients with iron deficiency anemia, both controlled-release ferrous glycine sulfate and ferrous fumarate were equally effective in increasing hemoglobin and other blood parameters over 4 weeks.
Ferrous glycine sulfate was associated with fewer gastrointestinal side effects compared to ferrous fumarate, suggesting it may be a better-tolerated option for patients.
A comparative trial of a controlled-release iron tablet preparation ('Ferrocontin' Continus) and ferrous fumarate tablets.Aronstam, A., Aston, DL.[2016]
Ferric carboxymaltose is an effective intravenous treatment for iron-deficiency anemia, rapidly improving hemoglobin levels and replenishing iron stores in various patient populations, including those with chronic kidney disease and inflammatory bowel disease, with a single dose of up to 1000 mg administered in 15 minutes.
The treatment is well tolerated, with mild to moderate side effects similar to those of oral iron supplements, and it shows a faster improvement in hemoglobin levels compared to ferrous sulfate, making it a preferred option for patients who cannot take oral iron.
Ferric carboxymaltose: a review of its use in iron-deficiency anaemia.Lyseng-Williamson, KA., Keating, GM.[2022]

Citations

Patient-Reported Outcomes After Ferric Carboxymaltose ...Mean serum hemoglobin was 10.2 ± 1.4 g/dL at baseline. All patients were treated with at least one FCM dose at baseline, with 77.6% receiving a ...
Efficacy, Safety, and Tolerability of Ferric Carboxymaltose and ...Our meta-analysis demonstrated that FCM provides a potential advantage over IS in improving Hb and ferritin levels among patients with IDA.
Effect of IV ferric carboxy maltose for moderate/severe ...A slow single infusion of 1 gram of FCM is well-tolerated, safe, and effective in treating iron deficiency anemia (IDA) and surpasses other interventions.
Effectiveness and safety of ferric carboxymaltose to treat ...Conclusions: Intravenous-iron improved hemoglobin levels both in actively treated and not-actively treated cancer patients. The effect has been ...
Efficacy and safety of intravenous ferric carboxymaltose ...We found that intravenous ferric carboxymaltose was more effective than oral iron therapy in correcting anaemia and iron deficiency, in line ...
Safety and Efficacy of Intravenous Ferric Carboxymaltose (750 ...Intravenous FCM is safe, well tolerated, and associated with improvements in hemoglobin and iron indices comparable to SMC when administered in single doses of ...
Safety, pharmacokinetics, and pharmacodynamics of ...This Phase 2, non-randomized, multicenter study characterized the safety profile and determined appropriate dosing of ferric carboxymaltose (FCM) in children ...
Effectiveness and safety of ferric carboxymaltose compared to ...Parenteral therapy is effective in IDA, but FCM elevates hemoglobin level and restored iron stores faster than IS with minimum adverse drug reactions.
Meta-analysis of efficacy and safety of intravenous ferric ...This review examined the available trials of intravenous ferric carboxymaltose using details from published papers and unpublished clinical trial reports.
Safety and Efficacy of High Dose Intravenous Ferric...Iron dextrans are associated with a substantial risk of fatal anaphylaxis (and high doses are not FDA approved). The available non-dextran irons must also be ...
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