Iron Deficiency AnaemiaEarly Phase 1NCT01991600
A Pilot Study to Assess the Influence of Dietary Organic Acids on Iron Absorption.
A Early Phase 1 study testing ferrous sulphate and ferric iron oxide-organic acid (Fe-OA) in people with Iron Deficiency Anaemia, run by Medical Research Council at 1 site in United Kingdom.
Trial summary
Iron deficiency is the most common micronutrient deficiency in the world today, affecting more than 60% of the global population (www.who.int/nut/ida.htm). The two main strategies for the prevention and treatment of iron deficiency involve fortification of food with iron, or direct supplementation with iron tablets. Read more about this study
- Who is it for?
- Ages 18 to 45 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Iron Deficiency Anaemia
- What is being tested?
- ferrous sulphate and ferric iron oxide-organic acid (Fe-OA)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 71 participants
- Where
- 1 siteUnited Kingdom
- Study dates
- May 2006to May 2010
- Phase
- Early Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Female aged 18-45 years.
- Low iron stores based on one of the following criteria:
- Mild iron deficiency anaemia defined as haemoglobin between 10-11.9 g/dL plus either a serum ferritin less than 20 μg/L or transferrin saturation < 10% or (II) iron deficiency defined as a serum ferritin less than 12 μg/L.
Who cannot join
- pregnancy and lactation
- surgery in the past three months
- cancer in last ten years
- known chronic infection
- chronic inflammation
- moderate or severe anaemia
Show all 15Show fewer
- known cardiovascular disease
- chronic respiratory disease.
- history of hereditary haemochromatosis or haemoglobinopathies
- current proton pump inhibitor medication
- blood donation/heavy blood loss in the last 3 months
- iron supplementation in the past 1 month
- chronic liver disease
- renal disease
- Coeliac Disease
Trial locations and contacts
1 site in 1 country.
United Kingdom1 site
MRC Human Nutrition Research
Cambridge, Cambridgeshire, CB1 9NL
About this study
Iron deficiency is the most common micronutrient deficiency in the world today, affecting more than 60% of the global population (www.who.int/nut/ida.htm). The two main strategies for the prevention and treatment of iron deficiency involve fortification of food with iron, or direct supplementation with iron tablets. Simple iron salts (e.g. ferrous sulphate) are well absorbed but at supplemental levels (and potentially at lower levels, as used in food fortificants) can induce free radical activity resulting in gastrointestinal side effects and systematic oxidative stress. As a result, supplementation has poor compliance and improvement in iron status is compromised. Ferric salts are less inclined to produce side effects and although they are relatively well absorbed at fortification levels in food, they are poorly absorbed at the higher supplemental doses. Because certain components of food, such as organic acids, can facilitate ferric iron absorption, we now wish to determine whether dietary organic acids may similarly enable efficient absorption of supplemental ferric iron while preventing the formation of non-transferrin-bound iron (NTBI) which is a proxy for free radical activity. Our strategy is to use an iterative process between in vitro and in vivo experimentation, aimed at identifying the best choice of organic acid and the optimal ratio of iron:organic acid. The study was a cross-over, single-dose comparison against standard-of-care therapy (namely ferrous sulphate) in mildly iron deficient anaemic women. Both the investigational products and the active comparator were administered as a single dose on 2 different occasions, i.e. the investigational products on the first study visit and the active comparator 14 days later on the second study visit.
Read the detailed description
The study was a first-in-human iron absorption study of ferric iron oxide-organic acid preparations (Fe-OAs). The study design was cross-over, single-dose, single-blinded comparison against standard-of-care therapy (namely ferrous sulphate) in mildly iron deficient anaemic women. Methyl-cellulose capsules containing single doses of Fe-OAs (60 mg elemental iron equivalent) were given to four subjects per test mixture to determine iron absorption and bioavailability. The study was initially designed in 2 parts (A and B). Part A was an iterative process to determine the best choice of organic acids and the optimal ratio of iron to organic acid that allowed efficient iron absorption, while part B was a comparison of absorption of the two most promising Fe-OA preparations against the standard-of-care therapy (namely ferrous sulphate). Following this iterative-based study we had a candidate Fe-OA preparation that showed nearly equivalent bioavailability to ferrous sulphate and we decided to stop the study at the end of Part A.
On day 1 of the study (Part A), the participants were given one methyl-cellulose capsule containing one of the Fe-OA preparations to be taken on an empty stomach or with a light breakfast consisting of water and 2 slices of white bread with jam. Participants were blinded to which test preparation they received. Serial serum iron levels were obtained at baseline and then 30, 60, 90, 120, 180, 210 and 240 minutes after ingestion of the iron dosage. Fourteen days later the participants returned for the second study visit where they ingested one ferrous sulphate tablet with a light breakfast, and the same visit protocol was followed. Each subject acted as her own control.
The bioavailability of iron from the Fe-OA preparations was determined by measuring erythrocyte incorporation of labelled iron 14 days following a single oral dose. Each Fe-OA preparation was labelled with 2 mg of the stable isotope 58Fe per single dose of the Fe-OA material. Ferrous sulphate was used as a reference for oral iron therapy and to determine individuals who were non-iron absorbers. Non-iron absorbers were defined as those who had no significant net area under the curve (AUC) for serum iron following ferrous sulphate oral ingestion (i.e. this was defined as a serum iron increase ≤ 5 μM). The data obtained for these individuals were excluded from the final analysis.
The bioavailability of ferrous sulphate was determined using short-term changes in serum iron levels using published algorithms.
- Conditions
- Iron Deficiency Anaemia
- Being tested
- ferrous sulphate, ferric iron oxide-organic acid (Fe-OA)
- Keywords
- iron absorption, bioavailability, anaemia, iron deficiency, ferrous sulphate
- Medical subject headings
- Anemia, Iron-Deficiency, Anemia, Iron Deficiencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ferrous sulphateDietary supplement
ferric iron oxide-organic acid (Fe-OA)Dietary supplement
| Study group | Role | What they receive |
|---|---|---|
| Ferrous Sulphate | Active comparator | The active comparator was the standard-of-care therapy for iron deficiency anaemia (namely ferrous sulphate). Generic uncoated ferrous sulphate tablets BP 300 mg containing 60mg elemental iron were purchased from a local pharmacy. The route of administration was oral. Each participant ingested one ferrous sulphate tablet (60 mg Fe) on one of the study visits. Receives: Dietary Supplement: ferrous sulphate |
| ferric iron oxide-organic acid (Fe-OA) | Experimental | Fifteen different ferric iron oxide-organic acid preparations were investigated. Most organic acids used were generally recognised as safe (GRAS) and all were used at dietary equivalent levels. The dosage was 58 ± 6 mg elemental iron equivalent (average of all compounds). The route of administration was oral using methyl-cellulose capsules. On one of the study visits, each participant ingested a single dose, equivalent to ca. 60 mg iron, of the Fe-OA preparation allocated to her. Receives: Dietary Supplement: ferric iron oxide-organic acid (Fe-OA) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Iron Bioavailability
The primary outcome was bioavailability of iron from ferric iron oxide-organic acid preparations (Fe-OA) as measured by erythrocyte incorporation of labelled iron (58Fe).
Measured: 14 days
Secondary outcomes (1)
Iron absorption
The secondary outcomes were total iron absorption and the rates of iron absorption in the 4 hours following the ingestion of the ferric iron oxide-organic acid preparations (Fe-OA)and the active comparator (namely ferrous sulphate).
Measured: 4 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Nov 2013 (estimated)
- Study startMay 2006
- Primary completionMay 2010
- Study completionMay 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Iron Deficiency AnaemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Early Phase 1
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 71 participants (actual)
Sponsor and investigators
- Lead sponsor
- Medical Research Council
- Sponsor type
- Other government
- Responsible party
- Principal investigator, dora pereira, Medical Research Council
- Investigators
- Jonathan Powell, PhD, Study chair, Medical Research Council
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01991600
- Sponsor's protocol ID
- 6129
- Status last verified
- Nov 2013
- First submitted
- 18 Nov 2013
- Last updated
- 25 Nov 2013
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 25 Nov 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Pilot Study to Assess the Influence of Dietary Organic Acids on Iron Absorption.
- ClinicalTrials.gov ID
- NCT01991600
- Acronym / sponsor ID
- 6129
- Conditions
- Iron Deficiency Anaemia
- Keywords
- iron absorption, bioavailability, anaemia, iron deficiency, ferrous sulphate
- Phase
- Early Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 71 participants (actual)
- Lead sponsor
- Medical Research CouncilOther government
- Study start
- May 2006
- Primary completion
- May 2010 (actual)
- Study completion
- May 2010 (actual)
- First posted
- 25 Nov 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Iron deficiency is the most common micronutrient deficiency in the world today, affecting more than 60% of the global population (www.who.int/nut/ida.htm). The two main strategies for the prevention and treatment of iron deficiency involve fortification of food with iron, or direct supplementation with iron tablets. Simple iron salts (e.g. ferrous sulphate) are well absorbed but at supplemental levels (and potentially at lower levels, as used in food fortificants) can induce free radical activity resulting in gastrointestinal side effects and systematic oxidative stress. As a result, supplementation has poor compliance and improvement in iron status is compromised. Ferric salts are less inclined to produce side effects and although they are relatively well absorbed at fortification levels in food, they are poorly absorbed at the higher supplemental doses. Because certain components of food, such as organic acids, can facilitate ferric iron absorption, we now wish to determine whether dietary organic acids may similarly enable efficient absorption of supplemental ferric iron while preventing the formation of non-transferrin-bound iron (NTBI) which is a proxy for free radical activity. Our strategy is to use an iterative process between in vitro and in vivo experimentation, aimed at identifying the best choice of organic acid and the optimal ratio of iron:organic acid. The study was a cross-over, single-dose comparison against standard-of-care therapy (namely ferrous sulphate) in mildly iron deficient anaemic women. Both the investigational products and the active comparator were administered as a single dose on 2 different occasions, i.e. the investigational products on the first study visit and the active comparator 14 days later on the second study visit.
Detailed description
The study was a first-in-human iron absorption study of ferric iron oxide-organic acid preparations (Fe-OAs). The study design was cross-over, single-dose, single-blinded comparison against standard-of-care therapy (namely ferrous sulphate) in mildly iron deficient anaemic women. Methyl-cellulose capsules containing single doses of Fe-OAs (60 mg elemental iron equivalent) were given to four subjects per test mixture to determine iron absorption and bioavailability. The study was initially designed in 2 parts (A and B). Part A was an iterative process to determine the best choice of organic acids and the optimal ratio of iron to organic acid that allowed efficient iron absorption, while part B was a comparison of absorption of the two most promising Fe-OA preparations against the standard-of-care therapy (namely ferrous sulphate). Following this iterative-based study we had a candidate Fe-OA preparation that showed nearly equivalent bioavailability to ferrous sulphate and we decided to stop the study at the end of Part A.
On day 1 of the study (Part A), the participants were given one methyl-cellulose capsule containing one of the Fe-OA preparations to be taken on an empty stomach or with a light breakfast consisting of water and 2 slices of white bread with jam. Participants were blinded to which test preparation they received. Serial serum iron levels were obtained at baseline and then 30, 60, 90, 120, 180, 210 and 240 minutes after ingestion of the iron dosage. Fourteen days later the participants returned for the second study visit where they ingested one ferrous sulphate tablet with a light breakfast, and the same visit protocol was followed. Each subject acted as her own control.
The bioavailability of iron from the Fe-OA preparations was determined by measuring erythrocyte incorporation of labelled iron 14 days following a single oral dose. Each Fe-OA preparation was labelled with 2 mg of the stable isotope 58Fe per single dose of the Fe-OA material. Ferrous sulphate was used as a reference for oral iron therapy and to determine individuals who were non-iron absorbers. Non-iron absorbers were defined as those who had no significant net area under the curve (AUC) for serum iron following ferrous sulphate oral ingestion (i.e. this was defined as a serum iron increase ≤ 5 μM). The data obtained for these individuals were excluded from the final analysis.
The bioavailability of ferrous sulphate was determined using short-term changes in serum iron levels using published algorithms.
Study design
- Primary purpose
- Basic science
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ferrous Sulphate | Active comparator | Dietary Supplement: ferrous sulphateThe active comparator was the standard-of-care therapy for iron deficiency anaemia (namely ferrous sulphate). Generic uncoated ferrous sulphate tablets BP 300 mg containing 60mg elemental iron were purchased from a local pharmacy. The route of administration was oral. Each participant ingested one ferrous sulphate tablet (60 mg Fe) on one of the study visits. |
| ferric iron oxide-organic acid (Fe-OA) | Experimental | Dietary Supplement: ferric iron oxide-organic acid (Fe-OA)Fifteen different ferric iron oxide-organic acid preparations were investigated. Most organic acids used were generally recognised as safe (GRAS) and all were used at dietary equivalent levels. The dosage was 58 ± 6 mg elemental iron equivalent (average of all compounds). The route of administration was oral using methyl-cellulose capsules. On one of the study visits, each participant ingested a single dose, equivalent to ca. 60 mg iron, of the Fe-OA preparation allocated to her. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Female aged 18-45 years.
- Mild iron deficiency anaemia defined as haemoglobin between 10-11.9 g/dL plus either a serum ferritin less than 20 μg/L or transferrin saturation < 10% or (II) iron deficiency defined as a serum ferritin less than 12 μg/L.
Key exclusion criteria (15 listed)
- pregnancy and lactation
- surgery in the past three months
- cancer in last ten years
- known chronic infection
- chronic inflammation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ferrous sulphate | Dietary supplement | Ferrous Sulphate |
| ferric iron oxide-organic acid (Fe-OA) | Dietary supplement | ferric iron oxide-organic acid (Fe-OA) |
Primary outcome
Iron Bioavailability
Time frame: 14 days
The primary outcome was bioavailability of iron from ferric iron oxide-organic acid preparations (Fe-OA) as measured by erythrocyte incorporation of labelled iron (58Fe).
1 secondary outcome
Iron absorption
Time frame: 4 hours
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Nov 2013.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jonathan Powell, PhD study chair
Medical Research Council
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Early Phase 1 study testing ferrous sulphate and ferric iron oxide-organic acid (Fe-OA) in people with Iron Deficiency Anaemia, run by Medical Research Council at 1 site in United Kingdom.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Nov 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Iron Bioavailability (time frame: 14 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Nov 2013.