The purpose of this study is to determine to what extend a treatment with the iron compounds Iron Isomaltoside 1000 or Ferric Carboxymaltose is leading to hypophosphatemia and to study the potential clinical impact of hypophosphatemia.
Recent studies suggested that intravenous iron preparations for anemia treatment may have adverse effects on phosphorus regulation, as they may induce an increase in the phosphaturic hormone Fibroblast Growth Factor-23 (FGF-23) and a subsequent fall in plasma phosphorus levels. So far it is unknown if these effects are class- or substance-specific. This study will address the question whether among female participants with iron deficiency anemia the application of ferric-(III)-derisomaltose and ferric carboxymaltose will cause episodes of hypophosphatemia to same extend. The investigators will additionally compare the effects of the two iron preparations on other parameters of calcium-phosphate metabolism, and decipher potential consequences of hypophosphatemia by analysing cardiac function, immunological parameters and quality of life. In order to investigate these outcomes, 60 women with iron deficient anemia will be randomised to receive either ferric-(III)-derisomaltose or ferric carboxymaltose. The monocentric study will be conducted at Saarland University Medical Center. For each participating woman, the study comprises five visits to the study center during a period of five weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
26
Universitätsklinikum des Saarlandes
Homburg, Saarland, Germany
Incidence of hypophosphatemia
The incidence of hypophosphatemia is defined as a drop of serum phosphate below 2.0 mg/dl.
Time frame: From baseline to day 35
Changes of plasma phosphate concentrations.
Time frame: From baseline to day 35
Changes of fractional Phosphate urinary excretion.
Time frame: From baseline to day 35
Changes of Plasma Vitamin D (active, inactive).
Time frame: From baseline to day 35
Changes of fibroblast growth factor 23 (intact and c-terminal).
Time frame: From baseline to day 35
Changes of parathyroid Hormone.
Time frame: From baseline to day 35
Changes of Plasma calcium.
Time frame: From baseline to day 35
Changes of Plasma alkaline Phosphatase.
Time frame: From baseline to day 35
Changes of Plasma soluble Klotho.
Time frame: From baseline to day 35
Changes of Plasma Hepcidin-25.
Time frame: From baseline to day 35
Changes of Serum N-Terminal Propeptide of Type I Collagen (PINP).
Time frame: From baseline to day 35
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Changes of Pyridinoline (PYD) in the urine
Time frame: From baseline to day 35
Changes of Quality of life.
German Version of the Short Form (36) Health Survey by Matthias Morfeld, Inge Kirchberger, Monika Bullinger.
Time frame: From baseline to day 35
Incidence of (supra)ventricular cardiac arrhythmias in the ambulatory Electrocardiography.
Time frame: Before and 7 days after administration of iron compound
Changes of QT-time in the 12-lead Electrocardiography.
Time frame: From baseline to day 35
Changes of QT-Dispersion in the 12-lead Electrocardiography.
Time frame: From baseline to day 35
Changes of Left Ventricular Mass Index
Echocardiographic measurement
Time frame: From baseline to day 7
Count of monocyte subpopulations.
Count of classical , intermediate and nonclassical monocytes using flow cytometry.
Time frame: Right before the singular infusion of the iron compound is started and right after infusion of the iron compound is completed.
Measurement of phagocytic capacity of monocytes.
Exposition of Monocytes to Fluoresbrite Yellow Green (YG) Carboxylate Microspheres and subsequent flow cytometric count of Fluorescein isothiocyanate-positive Monocytes.
Time frame: Right before the singular infusion of the iron compound is started and right after the infusion of iron compound is completed.
Changes of fatigue
The German Version of the Multidimensional Fatigue Inventory. (Smets E. M. A., Garssen B., Bonke B. and Haes de J. C. J. M. (1995). The Multidimensional Fatigue Inventory (MFI); Psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39, 315-325.)
Time frame: From baseline to day 35
Changes of Left Atrial Volume Index
Echocardiographic measurement
Time frame: From Baseline to day 7
Changes of Systolic Ejection Fraction
Echocardiographic measurement
Time frame: From Baseline to day 7
Changes of Diastolic Left Ventricular Function
Echocardiographic measurement
Time frame: From Baseline to day 7