Intravenous Iron in paTients With Heart failURe and Reduced Ejection fracTion (HFREF) pLus Iron dEficiency

NCT ID: NCT03079518

Last Updated: 2017-12-06

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-10

Study Completion Date

2017-10-25

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Effects of ferric carboxymaltose single HD (1000 mg) infusion upon FGF23 in patients with isolated HFREF compared to patients with HFREF+CKD (all pts with iron deficiency). This study aims at identification of the optimal target population for a follow-up ("main") study.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Iron deficiency is highly prevalent in patients with HFREF and intravenous high-dose (HD) iron application has significantly improved clinically meaningful endpoints in such patients. The best evidence is existent for ferric carboxymaltose. Intravenous HD iron may influence phosphate metabolism via increases in levels of intact FGF23 and hence induce prolonged hypophosphatemia. Such increases in FGF23 may particularly occur depending on the type of iron carrier.

FGF23 is a significant risk factor for mortality and morbidity in patients with HFREF and other cardiac populations at risk and may directly cause left ventricular hypertrophy and dysfunction. Hence, the application of i.v. HD iron may have potentially beneficial effects on cardiac function but harmful effects via FGF23-induction and hypophosphatemia at the same time. However, FGF23 metabolism has not yet been evaluated in HFREF patients following i.v. HD iron.

FGF23 is elevated in patients with chronic kidney disease. Patients with HFREF + CKD = chronic cardio-renal syndrome are at particular risk regarding elevated morbidity and mortality. The effects of intravenous HD iron upon phosphate and FGF23 metabolism in patients with HFREF + CKD is unknown and effects in this setting may be different compared to effects in patients without pre-existing FGF23 stimulation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Heart Failure, Systolic Iron Deficiency

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

iron deficiency HFREF FGF23 ferric carboxymaltose

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Patients with HFREF & CKD

treated with intravenous single-shot 1000mg Ferric Carboxymaltose infusion; additional intervention: blood withdrawal

Group Type ACTIVE_COMPARATOR

Ferric Carboxymaltose

Intervention Type DRUG

single shot infusion

blood withdrawal

Intervention Type OTHER

for determination of serum and urinary biomarkers of chronic kidney disease metabolism and other parameters

Patients with HFREF

treated with intravenous single-shot 1000mg Ferric Carboxymaltose infusion; additional intervention: blood withdrawal

Group Type ACTIVE_COMPARATOR

Ferric Carboxymaltose

Intervention Type DRUG

single shot infusion

blood withdrawal

Intervention Type OTHER

for determination of serum and urinary biomarkers of chronic kidney disease metabolism and other parameters

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Ferric Carboxymaltose

single shot infusion

Intervention Type DRUG

blood withdrawal

for determination of serum and urinary biomarkers of chronic kidney disease metabolism and other parameters

Intervention Type OTHER

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Ferinject

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Written informed consent.
* Age \> 18 yrs
* Symptomatic HFREF (LV ejection fraction \< 45%) with optimal medical therapy (OMT) for at least 2 months
* Iron deficiency as indicated by by ferritin \<100 ng/mL or ferritin 100-299 ng/ml when transferrin saturation (TSAT) \<20% and Hb value \< 13mg/dl (women) and \<14 mg/dl (men)
* Group A: Stable CKD for at least 2 months, defined by estimated glomerular filtration rate (eGFR) (CKD-EPI formula) as 15-60 ml/min/1,73 m3 (CKD III, IV, V-non D)
* Group B: patients with stable eGFR \> 60 ml/min/1,73 m3

Exclusion Criteria

* Known hypersensitivity to ferric carboxymaltose or any constituents of the formulation,
* Plasma Phosphate \< 2.5 mg/dL at screening,
* Renal replacement therapy/transplantation,
* Pregnancy or lactation
* iron substitution therapy or erythropoetin (epo) therapy within 6 weeks before
* participation in another clinical trial with an experimental drug
* expectation of missing compliance
* alcohol or drug abuse
* The subject is mentally or legally incapacitated
* patients who are in a relationship of dependence or in a working relationship to the sponsor, the investigator or his representative
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

RWTH Aachen University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Department of Medicine, Division of Cardiology, Pulmonary Diseases and Vascular Medicine at the University Hospital, RWTH Aachen

Aachen, North Rhine-Westphalia, Germany

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Germany

References

Explore related publications, articles, or registry entries linked to this study.

Stohr R, Sandstede L, Heine GH, Marx N, Brandenburg V. High-Dose Ferric Carboxymaltose in Patients With HFrEF Induces Significant Hypophosphatemia. J Am Coll Cardiol. 2018 May 15;71(19):2270-2271. doi: 10.1016/j.jacc.2018.03.448. No abstract available.

Reference Type DERIVED
PMID: 29747838 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

16-047

Identifier Type: -

Identifier Source: org_study_id