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Trial registered on ANZCTR
Registration number
ACTRN12611000928910
Ethics application status
Approved
Date submitted
29/08/2011
Date registered
30/08/2011
Date last updated
30/08/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Safety of a Rapid Infusion Protocol for Administration of Intravenous Iron Polymaltose
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Scientific title
This study will assess the immediate (during infusion) and delayed (up to 5 days) adverse events associated with rapid (over 1 hour) administration of intravenous iron polymaltose compared to standard administration (over 6 hours) in patients receiving iron infusions for iron deficiency in a hospital based outpatient setting.
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Secondary ID [1]
262941
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None
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Universal Trial Number (UTN)
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Trial acronym
RiFe
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Iron Deficiency
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Condition category
Condition code
Diet and Nutrition
270839
270839
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0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous Iron Polymaltose
Dose of iron polymaltose will be calculated based on the patients weight and haemoglobin level. A dosing table will be used in line with the organisations current intravenous iron policy. For participants who have been randomised to receive the rapid infusion the maximum dose of iron they will receive will be capped at 1500mg.
Rapid intravenous administration over approximately 1 hour.
Dose prescribed (up to a maximum of 1500mg) mixed with 250mls of Normal Saline.
Commencement of a test dose at a rate of 40mls/hr for 15 minutes. If tolerated the infusion will be increased to a rate of 250mls/hr until the end of the infusion.
The rapid infusion differs from the standard in that the volume of normal saline is half and the rate of the infusion will be approximately 1 hour as opposed to the standard rate of approximately 6 hours.
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Intervention code [1]
269285
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Treatment: Drugs
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Comparator / control treatment
Intravenous Iron Polymaltose
Standard treatment
Dose prescribed (up to 2500mg) mixed with 500mls of Normal Saline.
Commencement of a test dose at a rate of 20mls/hr for 30 minutes then, 40mls/hr for 30 minutes, then 90mls/hr for 30 minutes and then 120mls/hr for the remainder of the infusion.
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Control group
Active
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Outcomes
Primary outcome [1]
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The rate of adverse events experienced by participants during the infusion.
Potential adverse events may include; flushing, welts, rash, urticaria, headache, nausea and vomiting and bronchospasm. Less common adverse events may include; joint and muscle spasm, faintness, tachycardia, sweating, dizziness, syncope, hypotension and circulatory collapse, chest and back pain, arthralgia, chills, fever, angioneurotic oedema and generalised lymphadenopathy.
Adverse events will be graded in terms of severity. Mild - no observable patient discomfort. Moderate - observable patient discomfort. Severe - distress or cardiorespiratory compromise. Mild events will be assessed by the registered Nurses giving the infusion. Moderate or severe events will be assessed by a medical officer.
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Assessment method [1]
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Timepoint [1]
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During and on completion of the infusion.
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Primary outcome [2]
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The rate of delayed adverse events experienced by participants.
Adverse events will be graded in terms of severity. Mild - no daily activity limitation. Moderate - some daily activity limitation. Severe - requiring bed rest or medical assistance. The events will be assessed by a study investigator through a follow up phone call at 5 days post infusion. This investigator will be blinded as to whether the participant received the standard or the rapid dose.
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Assessment method [2]
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Timepoint [2]
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Up to 5 days following infusion.
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Secondary outcome [1]
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The type and severity of adverse events experienced by participants during and in the 5 days following the infusion.
Events during the infusion will be assessed by the registered nurses giving the infusion in the case of mild events and by a medical officer for moderate to severe events. A study investigator will assess delayed events via a telephone call to the participant 5 days following the infusion.
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Assessment method [1]
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Timepoint [1]
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During and in the 5 days following infusion.
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Eligibility
Key inclusion criteria
Patients with a confirmed diagnosis of iron deficeincy referred to a hospital based out patients department for intravenous iron infusion.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy
Class III or IV heart failure.
Left ventricular ejection fraction of <30%.
Chronic kidney disease with an estimated glomerular filtration rate of <15ml/min.
Otherwise deemed at risk of fluid overload.
All who do not currently meet the criteria for iron infusion according to current WDHB policy.
People who have restricted capability to make independent decisions about their participation in the study i.e. those with known cognitive impairment.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All potential participants information sent to study co-ordinator by the out patient unit when a booking has been made for them to receive their inron infusion.
Study co-ordinator will assess suitability for inclusion into study using initial iron infusion referral criteria and electronic medical records.
If criteria met study co-ordinator will contact patient by telephone, inform them of the study and confirm patient is suitable for inclusion. Study co-ordinator will then send out the participant information sheet and consent form.
On day of infusion a study investigator will assess the patient and gain written consent.
Allocation of treatment (allocation concealment).
Registered nurses within the out patients department will, following consent, take the next sequentially numbered opaque envelope containing either the rapid or standard iron administration protocol. They will then proceed to give the iron infusion as stated.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
25/08/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
116
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Waitemata District Health Board
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Address [1]
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Clinical Haematology
North Shore Hospital
Shakespeare Road, Takapuna
Auckland 0640
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Ross Henderson
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Address
Clinical Haematology
North Shore Hospital
Shakespeare Road, Takapuna
Auckland 0640
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
268786
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern X Regional Ethics Committee
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Ethics committee address [1]
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Private bag 92522 Wellesley Street Auckland 1141
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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08/08/2011
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Ethics approval number [1]
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NTX/11/07/060
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Summary
Brief summary
Iron deficiency anaemia is a common problem in the community. While many patients can tolerate oral iron supplements to replenish iron stores and correct the anaemia, a significant minority of patients, either cannot absorb oral iron or have side-effects which preclude its use. These patients are eligible to receive intravenous iron. Guidelines for use of intravenous iron indicate that it should be infused slowly (taking approximately 6 hours). This is inconvenient for patients, takes considerable nursing resource and limits access to outpatient day stay facilities. Anecdotal experience and a recent published paper suggest that intravenous iron can be given much faster (taking approximately 60 min), without undue side-effects. This will be a randomised study between rapid infusion and standard infusion rates of intravenous iron with immediate and delayed side-effects noted. If the rapid infusion rate is well tolerated this would then become the standard of care at the host institution.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Louise Bobbitt
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Address
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Clinical Haematology (Gingerbread House)
North Shore Hospital
Shakespeare Road
Takapuna, Auckland. 0640
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Country
16330
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New Zealand
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Phone
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+64 9 4868900 ext 3441
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Fax
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+64 9 4868921
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Ross Henderson
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Address
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Clinical Haematology (Gingerbread House)
North Shore Hospital
Shakespeare Road
Takapuna, Auckland. 0640
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Country
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New Zealand
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Phone
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+64 9 4868900
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Fax
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+64 9 4868921
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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