Iron Supplementation in Inflammatory Bowel Disease (IBD) Patients With Chronic Fatigue

Effects of Iron Therapy in Patients With Chronic Fatigue and IBD

A phase 2, randomized, placebo controlled trial evaluating the effects of n intravenous iron supplementation on chronic fatigue in IBD patients with controlled disease.

The study will evaluate a 6 months therapy with intravenous ferric carboxymaltose.

Patients will undergo a 2-5 days screening period and then will be treated every 4 weeks with iron supplementation/placebo.

At every visit, hematology and blood iron levels will be evaluated. Treatment will be temporarily stopped in case of either Hemoglobin levels above 16 g/dl or ferritin above 800 ng/ml (level decreased to 500 ng/ml in case of Transferrin-Iron Saturation Percentage above 50%).

Study team will be composed of blinded and unblinded personnel and dedicated infusion devices will be used to ensure the double blinding.

Inclusion Criteria:

• Diagnosis of Ulcerative Colitis or Crohn's Disease established at least 6 months prior to Day 1 by endoscopy and/or imaging
• At least 6 months of clinical remission (Harvey Bradshaw Index ≤5; Mayo clinical score ≤ 2)
• Therapy with mesalamine, immunosuppressors or anti-tumor necrosis factor alpha (TNFα) at stable doses for at least 3 months prior enrollment; steroids are not permitted from 6 months prior baseline
• Chronic fatigue symptoms (MFI-20>13)
• Iron deficiency: ferritin < 100 microg/l or < 300 microg/l in case of Transferrin-Iron Saturation Percentage (TSAT) <20%
• Women of childbearing potential must have a negative serum pregnancy test before enrollment.
• Able and willing to provide written informed consent

Exclusion Criteria:

• Known hypersensibility to active principle or excipients
• Pregnant or lactating women
• Clinically active IBD (Harvey Bradshaw Index >6; Mayo clinical score >3 or C-Reactive Protein >2.5 mg/L
• Renal failure (eGFR<60)
• History of adrenal insufficiency
• History of autoimmune diseases
• History of malignancies
• Depression
• Any current or recent signs or symptoms of viral infectious diseases
• Recent psycho-traumatic events
• Hemoglobin levels < 12.5 g/dl (men) or <11.5 g/dL (women)