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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05714007
Other study ID # PUMCH-Fe
Secondary ID
Status Recruiting
Phase Phase 4
First received
Last updated
Start date August 31, 2023
Est. completion date June 2025

Study information

Verified date September 2023
Source Peking Union Medical College Hospital
Contact Jianxiong Shen, MD
Phone 01069152701
Email sjxpumch@163.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The prognosis of patients undergoing spinal deformity surgery is often compromised by perioperative anemia due to iron deficiency. The aim of this randomized, controlled trial was to evaluate whether postoperative ferric derisomaltose intravenous injection may improve anemia and prognosis in patients undergoing spinal deformity surgery comparing with oral iron. Participants will be randomly assigned to the treatment group (intravenous ferric derisomaltose) and the control group (oral iron). Changes in hemoglobin concentration, percentage of anemia correction, changes in iron indicators, patient quality of life, and incidence of adverse events will be analyzed to evaluate the efficacy and safety of iron isomaltoside infusion.


Description:

Iron deficiency is a common cause of perioperative anemia in patients undergoing spinal deformity surgery. Anemia may lead to increased postoperative complications and mortalities, prolonged hospital stays, deteriorated physical function, and severely affect the quality of life. Oral iron has been widely recommended to treat perioperative anemia. However, the pro-inflammatory cytokines (such as IL-6 (Interleukin-6), TNF-a (Tumor necrosis factor-α)) produced by the inflammatory state after surgery can lead to an increase in hepcidin, which greatly affects the absorption of oral iron. Compared to oral iron, intravenous iron can circumvent the effects of decreased iron absorption in the gastrointestinal tract due to the postoperative inflammatory state and achieve faster and more effective iron supplementation. At present, intravenous iron supplements are mainly second-generation products, including iron sucrose and ferric gluconate. However, the unstable molecular structure of second-generation iron supplements may cause oxidative stress, which limits its administration in large doses. Compared with traditional intravenous iron, the third-generation iron preparations allow more iron (1000 mg (milligram) or more, no more than 20 mg/kg (kilogram)) to be infused within a short period of time (15-60 minutes), improving patient compliance, reducing costs and complications caused by multiple infusions, and is promising to improve anemia more rapidly. Ferric derisomaltose, as the only third-generation iron currently available in China market, has showed its value in treating anemia in joint replacement surgeries. However, the effectiveness of postoperative intravenous ferric derisomaltose in spinal deformity surgery remains uncertain. Therefore, we designed this prospective randomized trial to evaluate whether intravenous ferric derisomaltose may improve anemia and prognosis in patients undergoing spinal deformity surgery compared with oral iron.


Recruitment information / eligibility

Status Recruiting
Enrollment 120
Est. completion date June 2025
Est. primary completion date June 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria 1. Age =18 years 2. Received spinal deformity surgery 3. 70 g/L = Hb = 110 g/L at POD1, or Hb =120 g/L at POD1 with a decrease in Hb of =20 g/L compared with baseline 4. Informed consent was obtained voluntarily Exclusion Criteria 1. Women who are pregnant, breastfeeding, or planning to become pregnant. 2. known serious hypersensitivity to other parenteral iron products 3. Non-iron deficiency anemia (e.g., hemolytic anemia) 4. Decompensated liver insufficiency 5. Coexisting active infection 6. Drug abuse, including but not limited to opioids, amphetamines, methamphetamine, ketamine, etc. 7. Other conditions that the investigator considers inappropriate for participation (e.g. deafness, Parkinson's disease, communication disorders, etc.) 8. Participation in another clinical trial within three months prior to this study.

Study Design


Intervention

Drug:
Ferric derisomaltose
Single intravenous dose ferric derisomaltose
Ferrous succinate
Daily oral dose of 100 mg iron (ferrous succinate) tid postoperatively

Locations

Country Name City State
China Peking Union Medical College Hospital Beijing Beijing

Sponsors (2)

Lead Sponsor Collaborator
Peking Union Medical College Hospital Pharmacosmos A/S

Country where clinical trial is conducted

China, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in hemoglobin concentration Change in hemoglobin concentrations from POD(postoperative day)1 to POD14 At 14 days
Secondary Change in hemoglobin concentration Change in hemoglobin concentrations from POD1 to POD5 At 5 days
Secondary Change in hemoglobin concentration Change in hemoglobin concentrations from POD1 to POD35 At 35 days
Secondary Correction of anemia The percentage of effective correction of anemia (elevation of Hb >20g/L or Hb =120g/L) at POD5 At 5 days
Secondary Correction of anemia The percentage of effective correction of anemia (elevation of Hb >20g/L or Hb =120g/L) at POD14 At 14 days
Secondary Correction of anemia The percentage of effective correction of anemia (elevation of Hb >20g/L or Hb =120g/L) at POD35 At 35 days
Secondary Change in serum iron Change in serum iron from POD1 to POD5 At 5 days
Secondary Change in serum iron Change in serum iron from POD1 to POD14 At 14 days
Secondary Change in serum iron Change in serum iron from POD1 to POD35 At 35 days
Secondary Change in ferritin Change in ferritin from POD1 to POD5 At 5 days
Secondary Change in ferritin Change in ferritin from POD1 to POD14 At 14 days
Secondary Change in ferritin Change in ferritin from POD1 to POD35 At 35 days
Secondary Change in transferrin saturation Change in transferrin saturation from POD1 to POD5 At 5 days
Secondary Change in transferrin saturation Change in transferrin saturation from POD1 to POD14 At 14 days
Secondary Change in transferrin saturation Change in transferrin saturation from POD1 to POD35 At 35 days
Secondary Change in soluble transferrin receptor Change in soluble transferrin receptor from POD1 to POD5 At 5 days
Secondary Change in soluble transferrin receptor Change in soluble transferrin receptor from POD1 to POD14 At 14 days
Secondary Change in soluble transferrin receptor Change in soluble transferrin receptor from POD1 to POD35 At 35 days
Secondary EQ-5D Quality of life measured by EQ-5D (European Quality of Life-5 Dimensions) at POD5 At 5 days
Secondary EQ-5D Quality of life measured by EQ-5D at POD14 At 14 days
Secondary EQ-5D Quality of life measured by EQ-5D at POD35 At 35 days
Secondary Fatigue score Fatigue measured FACIT-F (The Functional Assessment of Chronic Illness Therapy-Fatigue) questionnaire at POD5 At 5 days
Secondary Fatigue score Fatigue measured FACIT-F questionnaire at POD14 At 14 days
Secondary Fatigue score Fatigue measured FACIT-F questionnaire at POD35 At 35 days
Secondary Barthel Index Independence in daily activities measured by the Barthel questionnaire at POD 5 At 5 days
Secondary Barthel Index Independence in daily activities measured by the Barthel questionnaire at POD 14 At 14 days
Secondary Barthel Index Independence in daily activities measured by the Barthel questionnaire at POD 35 At 35 days
Secondary Length of hospital stay Hospitalized days At 3 months
Secondary Adverse events Incidence of adverse events At 3 months
Secondary Infection Incidence of postoperative infection At 3 months
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