Effect of intravenous iron in alleviating symptoms of exhaustion in non-anaemic pre-menopausal women

ISRCTN ISRCTN78430425
DOI https://doi.org/10.1186/ISRCTN78430425
Secondary identifying numbers N/A
Submission date
14/02/2010
Registration date
17/03/2010
Last edited
30/06/2011
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Christian Breymann
Scientific

Gynakologie Geburtshilfe Seefeld
Seefeldstrasse
214
Zurich
CH-8008
Switzerland

Phone +41 (0)43 818 59 68
Email breymann@ggs-zh.ch

Study information

Study designRandomised multicentre double blind placebo controlled superiority study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use contact Lise Riopel [lise.riopel@viforpharma.com] to request a patient information sheet.
Scientific titleEffect of intravenous iron versus placebo on exhaustion symptoms in non-anaemic premenopausal women with low ferritin levels
Study acronymFERRIM
Study objectivesAdministration of intravenous iron to non-anemic pre-menopausal women with low serum ferritin (S-ferritin) levels will improve physical and mental performance

Please note that as of 24/05/10 a brief description of the study results has been added to this record. More details are available in the interventions section below.
Ethics approval(s)Both local and central ethical approval was obtained prior to study start - study conducted according to Swissmedic, ICH GCP guidelines and Declaration of Helsinki
Health condition(s) or problem(s) studiedReduced physical and mental performance in pre-menopausal women
InterventionVenofer®, (iron sucrose injection) is an aqueous complex of polynuclear iron (III)- hydroxide in sucrose for intravenous use. Patients received either 2 infusions each containing 200 mg iron [III]-hydroxide sucrose (Venofer®) or 2 infusions of 200 ml 0.9% saline (placebo) administered over a minimum period of 10 minutes each week for the first two weeks of the trial. Each patient received a total of 4 infusions representing a total of 800 mg of iron in the Venofer® treated group. Patients were followed for total period of 3 months.

Added 24/05/10:
Statistical methods:
For description of the distribution medians and range were used. For analysis of differences of distribution of investigated parameters between Venofer and placebo groups, a non parametric test (Mann- Whitney U-Test) was used. Both types of analyses were performed, because deviations from normal distribution were found for primary objective variables, most items are categorically scaled parameters.

Study Results:
1. Efficacy:
Difference from baseline in median Brief Fatigue Inventory (BFI) score between the treatment groups was not statistically significant but suggest a trend toward a greater improvement in patients treated with iron sucrose (difference in change BFI: -0.44, p=0.076). There was a significantly (p=0.036) greater improvement in categorized tBFI scores from baseline to Day 42 in patients treated with IV iron sucrose compared to patients treated with placebo There were significant differences between the study groups in some sub-group analyses. Among patients presenting with severe iron deficiency at baseline (defined as TSAT below 20% and serum ferritin below 50 ng/mL or serum ferritin below 15 ng/mL) there was a significantly greater improvement in BFI score at Day 42, in patients treated with IV iron sucrose compared to patients treated with placebo (p=0.026).
There was a significant correlation between the change in fatigue from baseline to Day 42 as measured by the BFI and the change in fatigue as measured by Short Performance Inventory (SPI), a global investigator assessment (r=0.59, p<0.0001).
Patients treated with IV iron sucrose showed a significant increase in serum-ferritin values during the study compared to baseline, and this increase was significantly greater in the IV iron sucrose group compared to the placebo group (p<0.0001).
The results of this study suggest a clinical benefit for patients treated with iron sucrose and warrant further investigation in this area.

2. Safety:
In total, 54 of 89 enrolled patients reported at least one adverse effect (AE) during the clinical study; most of the AEs were mild and unrelated to study medication. Two serious AEs (SAEs) were reported, one in each treatment group. There was one case of appendicitis and one serious traffic accident. Both were unrelated to treatment. Further, there were no clinically relevant abnormal findings in vital signs, physical exams or evaluation of concomitant medication during the study. This suggests that the iron sucrose treatment caused no safety concerns. It can be concluded that the incidence of AEs following iron sucrose administration is low and reflects the safety profile labelled in the SmPC.
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Specified
Drug / device / biological / vaccine name(s)Iron [III]-hydroxide sucrose (Venofer®)
Primary outcome measure1. Brief Fatigue Inventory (total score = tBFI) assessed at baseline, day 42 and 90
2. Serum ferretin, assessed at baseline, 3rd treatment visit, day 42 and 90
Secondary outcome measures1. BFI intensity mean score and impairment score, assessed at baseline, day 42 and 90
2. Haematological parameters, assessed at baseline, day 42 and 90
2.1. Hb
2.2. Mean corpuscular volume (MCV)
2.3. Mean corpuscular haemoglobin concentration (MCHC)
2.4. Haematocrit (HCT)
3. Iron status, assessed at baseline, 3rd treatment visit, day 42 and 90
3.1. Serum iron
3.2. Transferrin Saturation (Tsat)
3.3. Transferrin
4. Safety
4.1. Adverse effects
4.2. Physical exam, assessed at day 90
4.3. Body weight and height, assessed at day 90
4.4. Vital signs, assessed at baseline, day 42 and 90
4.5. Creatinine, assessed at baseline
4.6. Alanine Aminotransferase (ALT), assessed at baseline
4.7. Aspartate Aminotransferase (AST), assessed at baseline
4.8. C-Reactive protein (CRP), assessed at baseline, day 42 and 90
5. Concomitant medications
Overall study start date21/09/2006
Completion date07/08/2008

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexFemale
Target number of participants100 (50 patients/group)
Key inclusion criteria1. Premenopausal, regularly menstruating women
2. Age ≥ 18 years
3. S-ferretin < 50ng/mL
4. Signed informed consent
5. Reduced physical and mental performance (fatigue, depressive mood, dizziness, sleep disturbance, concentration, neck pain, headache) as determined by investigator
6. Adequate contraception
Key exclusion criteria1. Haemoglobin (Hb) level 120 g/L
2. Known mental and physical disorder (cancer, depression)
3. Use of concomitant medication to cause symptoms of fatigue and depression (antidepressive & chemotherapeutic agents, sedatives)
4. Use of iron preparations within previous 4-weeks
5. Active sever infection, inflammation, malignancy
6. C-Reactive Protein (CRP) > 20 mg/mL
7. Thyroid-Stimulating Hormone (TSH) > 4 micro U/mL
8. Use of menstruation depressing gestagens
9. History of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV)
10. Significant cardiovascular disease e.g. unstable angina, New York Heart Association (NYHA) class IV
11. Hypersensitivity to iron sucrose or iron sulphate
12. Pregnancy or lactation
13. Participation in any other therapeutic study in the previous month
Date of first enrolment21/09/2006
Date of final enrolment07/08/2008

Locations

Countries of recruitment

  • Switzerland

Study participating centre

Gynakologie Geburtshilfe Seefeld
Zurich
CH-8008
Switzerland

Sponsor information

Vifor Pharma, Vifor (International) Ltd (Switzerland)
Industry

Flughofstrasse 61
Glattbrugg
CH-8152
Switzerland

Phone +41 (0)58 851 80 00
Email clive.burge@viforpharma.com
Website http://www.viforpharma.com
ROR logo "ROR" https://ror.org/0185z7g17

Funders

Funder type

Industry

Vifor Pharma, Vifor (International) Ltd. (Switzerland)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 22/09/2011 Yes No