In order to evaluate the efficacy of ferric carboxymaltose + erythropoietin versus ferric carboxymaltose versus placebo in reducing the percentage of patients who receive red-cell transfusion in the perioperative period of hip fracture, a multicenter, randomized, parallel groups, double-blind clinical trial in adult patients admitted for osteoporotic hip fracture is designed. Required sample size is of 87 patients per arm (87x3 = 261). Primary efficacy variable is the percentage of patients who receive red-cell transfusion during hospitalization; secondary end-points: average red-cell packs per patient,haemoglobin at 24 h and 72h after the intervention, at the time of hospital discharge and 60 days after hospital discharge, hospital stay and mortality during hospital-stay and 60 days afterwards. Adverse clinical events and side effects are assessed as safety variables. In addition health related quality of life will be measured at inclusion and after 60 days. A cost-efficacy analysis (by means of incremental cost-efficacy method using as a primary endpoint each patient not requiring transfusion, and as secondary end-point every patient who survived the index admission is performed). The investigators would like to demonstrate a double benefits: optimizing precious resource such as blood products and reducing complications arising from their use.
Three arms of treatments: A: ferric carboxymaltose and erythropoietin, B: ferric carboxymaltose and placebo, arm C: two placebos. Primary objective:reduction of red-cell packs needed for elderly patients with osteoporotic hip fracture which requires surgical intervention in the perioperative period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
303
Ferinject®: Ferric carboxymaltose: 2 vials of 10 mL containing each 500 mg iron, diluted in 250 mL normal saline for injection. Study drug to be administered by infusion immediately after preparation. Placebo for erythropoietin: 1 mL normal saline for subcutaneous injection.
Erythropoetin: 40,000 units subcutaneous (unique dose).
Placebo for ferric carboxymaltose: 250 mL normal saline for intravenous administration. Placebo for erythropoietin: 1 mL normal saline for subcutaneous injection.
Hospital Universitario de Albacete
Albacete, Albacete, Spain
Hospital General Universitario de Elche
Elche, Alicante, Spain
Hospital de la Vega Baja
Orihuela, Alicante, Spain
Hospital Germans Trias i Pujol
Badalona, Barcelona, Spain
Hospital Universitario de Bellvitge
L'Hospitalet de Llobregat, Barcelona, Spain
Hospital Universitario Virgen del Rocío
Seville, España, Spain
Hospital Donostia
San Sebastián, Guipúzcoa, Spain
Hospital Infanta Elena
Huelva, Huelva, Spain
Hospital Lucus Augusti
Lugo, Lugo, Spain
Hospital de la Serranía de Ronda
Ronda, Malaga, Spain
...and 4 more locations
Reduce red-cell transfusion packs
percentage of patients who receive red-cell transfusion during hospitalization
Time frame: 60 days after hospital discharge
Average red-cell packs per patient
Time frame: end of study
Haemoglobin level
Time frame: 24 h and 72h after the intervention, at the time of hospital discharge and 60 days after hospital discharge
Number of hospitalization days
number of days inhospital
Time frame: end of study
Death rate with all causes mortality
Time frame: end of study
Adverse Events
adverse clinical events, side effects, Serious Adverse Events (SAE) and Suspected Unexpected Serious Adverse Reaction(SUSAR)
Time frame: end of study
Quality of life
health related quality of life
Time frame: end of study
cost-efficacy analysis
means of incremental cost-efficacy method (using as a primary endpoint each patient not requiring transfusion, and as secondary end-point every patient who survived the index admission)
Time frame: end of study
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