Effects of Ferinject® on Anemia and Transfusion Rates After Cardiac Surgery

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

PHASE4

Total Enrollment

194 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-15

Study Completion Date

2021-01-02

Brief Summary

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Several studies using new forms of intravenous iron showed that it is effective in treating perioperative anemia in orthopedic and digestive surgery. Effects of ferric carboxymaltose have not been assessed in the settings of cardiac surgery.

This study will compare ferric carboxymaltose to placebo in a randomized trial design where ferric carboxymaltose / placebo will be administered in the postoperative period (Day 1) after cardiac surgery. A total sample size of 200 patients (100 per group) will be needed.

The FCAACS trial will assess the impact of administering intravenous iron (Ferric carboxymaltose) after cardiac surgery with cardiopulmonary bypass (CPB) on the:

* incidence of postoperative anemia
* incidence of postoperative transfusion
* incidence of complications related to intravenous iron

All the surgeries will be performed by the same surgical team and follow-up will be ensured by the same Cardiac Surgery Unit (CSU) team according to department's standard protocols.

Participants in the Ferric carboxymaltose group will receive 1g of Ferric carboxymaltose diluted in 100 mL of IV isotonic serum saline, whereas participants in the Placebo group will receive 100 mL of IV Placebo

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Detailed Description

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Anemia is very common in the perioperative of major surgery affecting about 30% of patients preoperatively and more than 80% postoperatively. Anemia is an independent risk factor of morbi-mortality.

Iron deficiency is the first cause of anemia. Physiological reserves of iron are not important, and the correction of anemia after hemorrhage is very slow. Hence, it takes 90 days to return to 80% of the basic Hb level after a blood donation of 500ml, and more than 150 days (almost 6 months), if one is deficient in iron. This is why iron is used to correct anemia that occurs after bleeding. There are two routes for iron administration: oral and intravenous.

Gastrointestinal absorption of iron is limited to 10-15 mg/d even when ingested doses are increased. This absorption is decreased in the presence of an inflammatory state, which is very common in the postoperative period.

The intravenous route allows the delivery of significantly higher doses of iron (up to 1000 mg in 1 infusion), without any limitation related to absorption. This is why it is interesting to administer it perioperatively where the expected delays are short.

There are currently new intravenous iron formulations that have two advantages: a shorter intravenous injection time and a higher maximum injectable dose per infusion. These new forms are risk-free, with no serious allergy described so far in the literature.

Several studies using new forms of intravenous iron showed that it is effective in treating perioperative anemia in orthopedic and digestive surgery. Effects of ferric carboxymaltose have not been assessed in the settings of cardiac surgery.

To assess the impact of ferric carboxymaltose in cardiac surgery, it will be compared to placebo in a randomized trial design, where ferric carboxymaltose / placebo will be administered in the postoperative period. Ferric carboxymaltose / placebo will be an add-on to the current treatment of patients in the postoperative period of cardiac surgery, the group that will be receiving placebo reflects the current management of the patients in these settings.

The FCAACS trial will assess the impact of administering intravenous iron (Ferric carboxymaltose) after cardiac surgery with cardiopulmonary bypass (CPB) on the:

* incidence of postoperative anemia
* incidence of postoperative transfusion
* incidence of complications related to intravenous iron

FCAACS will be a parallel group randomized trial, with a 2-group design and no crossover. Allocation ratio will be 1/1, in an equivalence framework. A total sample size of 200 patients (100 per group) will be needed.

Conditions

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Anemia, Iron Deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

FCAACS will be a parallel group randomized trial, with a 2-group design and no crossover. Allocation ratio will be 1/1, in an equivalence framework.

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Ferric Carboxymaltose group

Ferric carboxymaltose group will receive 1g of Ferric carboxymaltose at day 1 following cardiac surgery

Group Type ACTIVE_COMPARATOR

Ferric carboxymaltose

Intervention Type DRUG

1g of Ferric carboxymaltose diluted in 100 mL of IV isotonic serum saline at day 1 following surgery

Placebo group

Placebo group will receive 100 mL of IV isotonic serum saline at day 1 following cardiac surgery

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

100 mL of IV isotonic serum saline at day 1 following surgery

Interventions

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Ferric carboxymaltose

1g of Ferric carboxymaltose diluted in 100 mL of IV isotonic serum saline at day 1 following surgery

Intervention Type DRUG

Placebo

100 mL of IV isotonic serum saline at day 1 following surgery

Intervention Type DRUG

Other Intervention Names

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Ferinject® Serum saline

Eligibility Criteria

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Exclusion Criteria

* Patients \< 18 years
* Urgent surgery
* Off-pump cardiac surgery
* Redo cardiac surgery
* Preoperative anemia (Hb \< 10g/l or Ht \< 30%)
* Transfusion within 72h preoperatively
* Pregnancy
* History of asthma or other specific allergies
* History of allergy to iron
* Acute infection
* Hepatic insufficiency
* Renal insufficiency (creatinine Clearance \< 30ml/min)

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No