Oral Iron Therapy in Chronic Heart Failure Patients

NCT ID: NCT02698046

Last Updated: 2016-03-03

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2016-10-31

Brief Summary

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This study is design to evaluate the effectiveness of oral iron therapy in patients with heart failure and identify the central and peripheral mechanisms involved in the improvement of functional capacity after intervention. The investigation includes subjective and objective measures on exercise performance and heart function after intervention, and the tolerability of oral iron treatment.

Detailed Description

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This is a placebo-controlled, double-blind and randomized clinical trial that will include patients with symptomatic stable chronic heart failure (New York Heart Association Functional Class II or III), with diagnosis of iron deficiency (ferritin \<100 ng / dL or ferritin between 100 - 300 ng / dL and transferrin saturation \<20%) followed in an outpatient clinic. The enrolled patients (n = 36) will be randomly allocated in the ratio 2:1 to treatment with 60 mg of elemental iron orally (n = 24) or placebo administration (n = 12), 3 times daily for 4 months. The primary outcome investigated will be an increase of the transferrin saturation ≥ 10 percentage points between baseline and after the intervention. Secondary outcomes of the study will be the change in iron stores, red blood cell indices, neurohumoral activation, left ventricular systolic function, functional capacity, mechanoreflex activity, and quality life score.

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Ferrous sulfate

Group Type EXPERIMENTAL

Ferrous sulfate

Intervention Type DIETARY_SUPPLEMENT

200mg of ferrous sulfate three times a day for 4 months

Placebo

Group Type PLACEBO_COMPARATOR

Placebo starch

Intervention Type DIETARY_SUPPLEMENT

200mg of placebo starch three times a day for 4 months

Interventions

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Ferrous sulfate

200mg of ferrous sulfate three times a day for 4 months

Intervention Type DIETARY_SUPPLEMENT

Placebo starch

200mg of placebo starch three times a day for 4 months

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Both gender patients aged over 18 years;
* Diagnosis of chronic heart failure (identified by the use of Framingham criteria) for ≥ 6 months;
* New York Heart Association functional class II and III;
* Left ventricular ejection fraction ≤ 45%
* Regular attendance in an outpatient Heart Failure Clinic;
* Adequate therapeutic drug for heart failure syndrome based on beta-adrenergic blocker, angiotensin converting enzyme inhibitor or angiotensin receptor blocker, and mineralocorticoid receptor blocker;
* Evidence of iron deficiency in biochemical analyses: ferritin values \< 100 ng/dL or between 100 ng/dL and 300 ng/dL, with transferrin saturation \< 20%;
* Hemoglobin value between 9,0 - 16 g/dL;
* Provide written informed consent.

Exclusion Criteria

* Recent device implant (in the last 3 months) or perspective of device implantation (conventional or multisite pacing) in the next 6 months;
* Known active infection, inflammatory disease or C-reactive protein \> 20 mg/dL
* Immunosuppressive therapy;
* In use of erythropoietin and/or current treatment with oral or intravenous iron;
* Clinically bleeding or blood transfusion in previous 3 months;
* Renal failure on dialysis;
* Hemoglobinopathies, hemochromatosis or active malignancy;
* Unstable angina pectoris or clinically significant uncorrected valvular disease, except mitral and tricuspid regurgitation secondary to ventricular dilatation;
* Acute myocardial infarction or acute coronary syndrome, transient ischaemic attack within the last 3 months;
* Uncontrolled arterial hypertension;
* Evidence of comorbidity that features active systemic disease, i.e. liver disease, collagen disease and untreated hyperthyroidism or hypothyroidism;
* Pregnant or lactating women;
* Anaemia due to reasons other than iron deficiency (i.e. vitamin B12 deficiency);
* Recent admission for decompensated heart failure (last 3 months).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundação de Amparo à Pesquisa do Estado de São Paulo

OTHER_GOV

Sponsor Role collaborator

University of Sao Paulo

OTHER

Sponsor Role lead

Responsible Party

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Jaqueline Rodrigues de Souza Gentil

Master degree

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jaqueline RS Gentil, Master

Role: PRINCIPAL_INVESTIGATOR

University of Sao Paulo

Locations

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Division of Cardiology, Department of Internal Medicine

Ribeirão Preto, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Jaqueline RS Gentil, Master

Role: CONTACT

+551633154577

Facility Contacts

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Jaqueline RS Gentil, Master

Role: primary

+551633154577

Marcus V Simoes, PhD

Role: backup

+551636022791

References

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Anker SD, Comin Colet J, Filippatos G, Willenheimer R, Dickstein K, Drexler H, Luscher TF, Bart B, Banasiak W, Niegowska J, Kirwan BA, Mori C, von Eisenhart Rothe B, Pocock SJ, Poole-Wilson PA, Ponikowski P; FAIR-HF Trial Investigators. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med. 2009 Dec 17;361(25):2436-48. doi: 10.1056/NEJMoa0908355. Epub 2009 Nov 17.

Reference Type BACKGROUND
PMID: 19920054 (View on PubMed)

Jankowska EA, Rozentryt P, Witkowska A, Nowak J, Hartmann O, Ponikowska B, Borodulin-Nadzieja L, Banasiak W, Polonski L, Filippatos G, McMurray JJ, Anker SD, Ponikowski P. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J. 2010 Aug;31(15):1872-80. doi: 10.1093/eurheartj/ehq158. Epub 2010 Jun 21.

Reference Type BACKGROUND
PMID: 20570952 (View on PubMed)

Okonko DO, Mandal AK, Missouris CG, Poole-Wilson PA. Disordered iron homeostasis in chronic heart failure: prevalence, predictors, and relation to anemia, exercise capacity, and survival. J Am Coll Cardiol. 2011 Sep 13;58(12):1241-51. doi: 10.1016/j.jacc.2011.04.040.

Reference Type BACKGROUND
PMID: 21903058 (View on PubMed)

Other Identifiers

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13/03301-1

Identifier Type: -

Identifier Source: org_study_id

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