Not Yet RecruitingPhase 2Phase 3ACTRN12619000283178

The IRONWOMAN pilot feasibility study: oral versus intravenous iron therapy for iron deficiency anaemia in late pregnancy

The IRONWOMAN pilot feasibility study: a double blind randomised trial to compare feasibility of blinding of intravenous or oral iron replacement to placebo intravenous or oral therapy for iron deficiency anaemia in pregnancy


Sponsor

Dr Amanda Henry

Enrollment

50 participants

Start Date

Apr 1, 2019

Study Type

Interventional

Conditions

Summary

Iron-deficiency anaemia (IDA) affects approximately 1 in 7 Australian pregnant women, and optimal treatment for improving maternal wellbeing and decreasing blood transfusion remains uncertain. An issue with prior randomised trials of IV versus oral iron is lack of patient and clinician blinding to treatment received, so the primary aim of this study is therefore to determine the feasibility and effectiveness of blinding treatment allocation to IV iron or saline placebo infusion. Participants will be pregnant women with iron deficiency anaemia between 26 weeks and 33 weeks gestation, and will either be given IV iron and placebo capsules or iron capsules and placebo IV. It is expected that using an opaque sleeve covering the syringe and giving set when administering IV iron or saline placebo, followed by matching placebo or active iron oral tablets, respectively, is feasible and effective.


Eligibility

Sex: FemalesMin Age: 18 Yearss

Inclusion Criteria1

  • Pregnant adult women (18 or more years of age) with singleton or twin pregnancy, and mild-moderate iron-deficiency anaemia of pregnancy (Haemoglobin 80-104 g/L and Ferritin <30µg/L) between 26 and 32+6 weeks’ gestation.

Exclusion Criteria1

  • Age<18 years, higher-order multiple pregnancy, severe anaemia (haemoglobin <80g/L), anaemia without iron deficiency, known malabsorptive syndromes affecting the uptake of oral iron, contraindication/known hypersensitivity to either oral iron or intravenous iron, already received intravenous iron during this pregnancy or taking 80+mg/day of elemental iron for the last 2 weeks, active severe mental health condition or intellectual disability precluding informed consent, women with active bleeding, women who are likely to give birth in the next 6 weeks, blood transfusion this pregnancy, history of anaemia due to another cause e.g. thalassemia, hypersplenism or haemolytic anaemia or iron overload or disorders in iron utilisation

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Interventions

Women will receive: 1) Intravenous ferric carboxymaltose (FCM) 1000mg on a single occasion following treatment allocation, and daily placebo capsules (composition not yet determined) from IV infusion

Women will receive: 1) Intravenous ferric carboxymaltose (FCM) 1000mg on a single occasion following treatment allocation, and daily placebo capsules (composition not yet determined) from IV infusion to birth OR 2) Elemental oral iron capsules 80mg daily from IV infusion to birth and a placebo intravenous saline infusion on a single occasion following treatment allocation. Both groups will begin capsules on the same day as the IV infusion, which will occur at a time suitable for the woman and the hospital. Strategies to monitor adherence to the capsules include a participant medication diary, direct observation by study personnel of pill count at 4 weeks after the IV, and questions in follow-up surveys at 8 weeks post-infusion and 6 weeks post-partum.


Locations(2)

Royal Hospital for Women - Randwick

NSW, Australia

St George Hospital - Kogarah

NSW, Australia

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ACTRN12619000283178