Iron Status and Human Metabolism

NCT ID: NCT02308449

Last Updated: 2022-07-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2016-01-31

Brief Summary

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Iron deficiency is common in cardiorespiratory diseases and appears to contribute to a worse outcome. This human physiology study will examine the extent to which human skeletal muscle metabolism and exercise physiology are impaired by iron deficiency.

Detailed Description

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This is a prospective double-blind randomised controlled study of the effect of endogenous iron status on skeletal muscle metabolism and exercise physiology. 32 healthy volunteers will take part, half of whom will be iron-deficient. The study involves a screening visit and two half-day visits during which assessments are performed. 50% of each group will be randomised to receive iron-repletion with ferric carboxymaltose at the end of the first experimental visit before returning to repeat identical assessments around one week later. This approach will make it possible to explore whether baseline differences in skeletal muscle metabolism are explained by differences in iron status per se, whilst controlling for any learning effect during participation in the study.

Conditions

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Iron Deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Iron-deficient, given placebo

Iron-deficient participants given an infusion of sodium chloride at conclusion of baseline experimental visit

Group Type PLACEBO_COMPARATOR

Sodium chloride (placebo)

Intervention Type DRUG

Infusion of 250 mL 0.9% sodium chloride

Iron-deficient, given iron

Iron-deficient participants given an infusion of ferric carboxymaltose at conclusion of baseline experimental visit

Group Type ACTIVE_COMPARATOR

Ferric carboxymaltose

Intervention Type DRUG

Infusion of 15 mg/kg (up to maximum 1000 mg) ferric carboxymaltose in 250 mL 0.9% sodium chloride

Iron-replete, given placebo

Iron-replete participants given an infusion of sodium chloride at conclusion of baseline experimental visit

Group Type PLACEBO_COMPARATOR

Sodium chloride (placebo)

Intervention Type DRUG

Infusion of 250 mL 0.9% sodium chloride

Iron-replete, given iron

Iron-deficient participants given an infusion of ferric carboxymaltose at conclusion of baseline experimental visit

Group Type ACTIVE_COMPARATOR

Ferric carboxymaltose

Intervention Type DRUG

Infusion of 15 mg/kg (up to maximum 1000 mg) ferric carboxymaltose in 250 mL 0.9% sodium chloride

Interventions

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Ferric carboxymaltose

Infusion of 15 mg/kg (up to maximum 1000 mg) ferric carboxymaltose in 250 mL 0.9% sodium chloride

Intervention Type DRUG

Sodium chloride (placebo)

Infusion of 250 mL 0.9% sodium chloride

Intervention Type DRUG

Other Intervention Names

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Ferinject Normal saline

Eligibility Criteria

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Inclusion Criteria

* Willing and able to give informed consent for participation in the study
* Men and women aged 18 years or older and generally in good health
* For iron-deficient volunteers: ferritin ≤ 15 microg/L and transferrin saturation \< 16%
* For iron-replete volunteers: ferritin ≥ 20 microg/L and transferrin saturation ≥ 20%

Exclusion Criteria

* Haemoglobin \< 8.0 g/dL
* Haemoglobinopathy
* Iron overload, defined as ferritin \> 300 microg/L
* Hypoxaemia (SpO2 \< 94%) or significant co-morbidity that may affect haematinics, metabolic or ventilatory responses
* Iron supplementation or blood transfusion within the previous 6 weeks
* Pregnancy or breast feeding
* Inability to exercise isolated calf muscle using a pedal or on a bicycle ergometer
* Contraindication to magnetic resonance spectroscopy exposure such as metallic implant
* Contraindication to receiving intravenous ferric carboxymaltose
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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British Heart Foundation

OTHER

Sponsor Role collaborator

National Institute for Health Research, United Kingdom

OTHER_GOV

Sponsor Role collaborator

University of Oxford

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter A Robbins, DPhil

Role: STUDY_DIRECTOR

University of Oxford

Matthew C Frise, MRCP

Role: PRINCIPAL_INVESTIGATOR

University of Oxford

Locations

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University of Oxford OCMR & CCRF, John Radcliffe Hospital

Oxford, Oxfordshire, United Kingdom

Site Status

Countries

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United Kingdom

References

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Formenti F, Constantin-Teodosiu D, Emmanuel Y, Cheeseman J, Dorrington KL, Edwards LM, Humphreys SM, Lappin TR, McMullin MF, McNamara CJ, Mills W, Murphy JA, O'Connor DF, Percy MJ, Ratcliffe PJ, Smith TG, Treacy M, Frayn KN, Greenhaff PL, Karpe F, Clarke K, Robbins PA. Regulation of human metabolism by hypoxia-inducible factor. Proc Natl Acad Sci U S A. 2010 Jul 13;107(28):12722-7. doi: 10.1073/pnas.1002339107. Epub 2010 Jun 28.

Reference Type BACKGROUND
PMID: 20616028 (View on PubMed)

Smith TG, Talbot NP, Privat C, Rivera-Ch M, Nickol AH, Ratcliffe PJ, Dorrington KL, Leon-Velarde F, Robbins PA. Effects of iron supplementation and depletion on hypoxic pulmonary hypertension: two randomized controlled trials. JAMA. 2009 Oct 7;302(13):1444-50. doi: 10.1001/jama.2009.1404.

Reference Type BACKGROUND
PMID: 19809026 (View on PubMed)

Smith TG, Balanos GM, Croft QP, Talbot NP, Dorrington KL, Ratcliffe PJ, Robbins PA. The increase in pulmonary arterial pressure caused by hypoxia depends on iron status. J Physiol. 2008 Dec 15;586(24):5999-6005. doi: 10.1113/jphysiol.2008.160960. Epub 2008 Oct 27.

Reference Type BACKGROUND
PMID: 18955380 (View on PubMed)

Smith TG, Brooks JT, Balanos GM, Lappin TR, Layton DM, Leedham DL, Liu C, Maxwell PH, McMullin MF, McNamara CJ, Percy MJ, Pugh CW, Ratcliffe PJ, Talbot NP, Treacy M, Robbins PA. Mutation of von Hippel-Lindau tumour suppressor and human cardiopulmonary physiology. PLoS Med. 2006 Jul;3(7):e290. doi: 10.1371/journal.pmed.0030290.

Reference Type BACKGROUND
PMID: 16768548 (View on PubMed)

Finch CA, Gollnick PD, Hlastala MP, Miller LR, Dillmann E, Mackler B. Lactic acidosis as a result of iron deficiency. J Clin Invest. 1979 Jul;64(1):129-37. doi: 10.1172/JCI109431.

Reference Type BACKGROUND
PMID: 447849 (View on PubMed)

Frise MC, Holdsworth DA, Johnson AW, Chung YJ, Curtis MK, Cox PJ, Clarke K, Tyler DJ, Roberts DJ, Ratcliffe PJ, Dorrington KL, Robbins PA. Abnormal whole-body energy metabolism in iron-deficient humans despite preserved skeletal muscle oxidative phosphorylation. Sci Rep. 2022 Jan 19;12(1):998. doi: 10.1038/s41598-021-03968-4.

Reference Type RESULT
PMID: 35046429 (View on PubMed)

Other Identifiers

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13/SC/0439

Identifier Type: -

Identifier Source: org_study_id

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