Randomized Trial of Intravenous Ferric Derisomaltose Versus Oral Iron for Severe Iron Deficiency Anemia from Uterine Bleeding in Women Presenting to the Emergency Department
Led by Baylor College of Medicine · Updated on 2024-12-05
40
Participants Needed
1
Research Sites
4 weeks
Total Duration
AI-Summary
What this Trial Is About
This research aims to evaluate the effectiveness of intravenous IV Ferric Derisomaltose compared to oral iron in treating women with severe iron deficiency anemia caused by uterine bleeding who present to the emergency department. Iron deficiency anemia is a common blood disorder, especially among women with abnormal uterine bleeding, and there is limited guidance on managing this condition in emergency settings. The study addresses concerns about overuse of blood transfusions and investigates newer IV iron formulations that may be safer and more effective than traditional oral treatments.
Participants will be randomly assigned to receive either a single intravenous dose of 1000 mg Ferric Derisomaltose administered over at least 20 minutes or oral ferrous sulfate 65 mg once daily for 42 days. The study includes a phase for initial treatment followed by assessments at 3 and 6 weeks to evaluate changes in hemoglobin levels. This design allows comparison of the two iron therapies in the acute care context of the emergency department.
During the study, women will attend follow-up visits at 3 and 6 weeks where their hemoglobin concentration will be measured to assess treatment response. Researchers will monitor adherence, safety, and quality of life, focusing on the mean change in hemoglobin as the primary outcome at 3 weeks, with additional evaluation at 6 weeks. Participants must be reachable by phone and able to attend these visits, with the total study duration spanning at least 6 weeks after enrollment.
CONDITIONS
Brief Title
IV Iron Trial for Anemia Related to Uterine Bleeding in Female Patients Presenting to the Emergency Department
Research Team
S
Stephen Boone, MD
K
Kelly R Keene, BSN
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This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
IV Ferric Derisomaltose
Oral Iron
What it is
Single dose injection of IV ferric derisomaltose (Monoferric), an intravenous iron compound, administered to replenish iron stores in women with moderate to severe iron deficiency anemia due to uterine bleeding.
Once-daily oral ferrous sulfate (65 mg elemental iron, 325 mg tablet), taken at home for 42 days to treat iron deficiency anemia in women with uterine bleeding.
Role in Trial
This arm tests IV iron as a rapid replacement therapy for iron deficiency anemia following uterine bleeding, assessing its effectiveness for patients eligible for discharge from the Emergency Department.
This arm evaluates standard oral iron therapy for the same patients, comparing its efficacy and recovery against IV iron in discharged Emergency Department patients.
Primary Use
Intended for rapid correction of iron deficiency anemia, especially in moderate to severe cases after uterine bleeding.
Used to treat iron deficiency anemia gradually, relying on daily dosing for moderate to severe cases post uterine bleeding.
How it is given or performed
Single intravenous infusion (1000 mg in 10 mL), administered in the Emergency Department before discharge.
One tablet (325 mg) containing 65 mg elemental iron taken orally once per day for 42 days at home.
Evidence Status
IV iron is supported by clinical studies showing faster rise in hemoglobin and improved iron stores compared to oral iron, especially in moderate to severe anemia and emergency settings.
Oral iron is established as effective in gradually correcting iron deficiency anemia, though literature finds slower response than IV iron and variable absorption, especially in severe cases.
Important Limitations
Single-dose IV iron may require IV access and has a low but present risk of hypersensitivity reactions. The need for ED administration may limit convenience for some patients.
Oral iron can cause gastrointestinal side effects and requires daily dosing for several weeks, which may lead to poor adherence and variable efficacy, especially in moderate to severe cases.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 18Years - 65Years
FEMALE
Eligibility Criteria
You may qualify if you...
Sub-acute or chronic uterine blood loss
Moderate to severe anemia with hemoglobin less than or equal to 9.0 g/dl
Iron deficiency with serum ferritin less than or equal to 30 ng/mL
Eligible for discharge from the emergency department after treatment
Able to return for follow-up visits at 3 and 6 weeks
Able to be contacted by telephone
Willing and able to provide consent for participation
You will not qualify if you...
Requires hospitalization for any reason
Pregnant or nursing
Incarcerated or prisoner
Weight less than 50 kg
History of hypersensitivity to any parenteral iron formulation
History of any anaphylactic allergy
Recent use of intravenous iron or erythropoiesis-stimulating agents
Use of erythropoiesis-stimulating agents within 8 weeks prior to emergency visit
Use of parenteral iron within 4 weeks prior to emergency visit
Planned use of parenteral iron or erythropoiesis-stimulating agents during study
Received blood transfusion at initial visit
Planned major elective surgery during study
Use of other recent hematologic therapy
Current or planned antithrombotic therapy (excluding non-aspirin NSAIDs)
Known bleeding disorder with platelets under 100,000
Active rheumatologic disease requiring treatment
Acute or chronic heart failure NYHA II-IV
Inflammatory bowel disease
Cirrhosis or decompensated liver disease
Chronic kidney disease stage III or greater (eGFR below 60)
Current systemic infection excluding cystitis or cervicitis
Any other condition making participation unsuitable by physician judgment
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - 42 days
Participants receive either a single intravenous dose of ferric derisomaltose or take oral ferrous sulfate daily for 42 days to treat iron deficiency anemia.
1 visit for intravenous infusion or daily oral medication for 42 days
Follow-up
Duration - Up to 6 weeks after treatment
Participants return for follow-up visits to assess changes in hemoglobin concentration and overall response to treatment.
2 visits (at 3 weeks and 6 weeks post-treatment)
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Management of Nonpregnant Women Presenting to the Emergency Department With Iron Deficiency Anemia Caused by Uterine Blood Loss: A Retrospective Cohort Study.
Stephen Boone, W Frank Peacock, Edgardo Ordonez...
Early intravenous iron administration in the Emergency Department reduces red blood cell unit transfusion, hospitalisation, re-transfusion, length of stay and costs.
Ivo Beverina, Giancarlo Razionale, Monica Ranzini...
A fast-track anaemia clinic in the Emergency Department: feasibility and efficacy of intravenous iron administration for treating sub-acute iron deficiency anaemia.
Manuel Quintana-Díaz, Sara Fabra-Cadenas, Susana Gómez-Ramírez...