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ERADAL-HF is a double blinded, multi-centre, prospective, randomized, three arm study, enrolled ambulatory patients with chronic heart failure [New York Heart Association (NYHA) class II/III], with iron deficiency [defined as ferritin <100 ng/mL, or ferritin 100-300 ng/mL if transferrin saturation (TSAT) <20%] and haemoglobin (Hb) < 15 g/dL. Patients were randomized 1:1:1 to treatment into three arms: a first group treated with intravenous iron supplementation, a second treated by intramuscular iron supplementation and the third one which have received placebo. These patients were followed-up during a period of 04 weeks.
The aim of this study is to assess the short term effect of parenteral iron supplementation on exercise tolerance and oxidative stress in patients with stable chronic heart failure and iron deficiency
ERADAL-HF is a double blinded, multi-centre, prospective, randomized, three arm study, enrolled ambulatory patients with chronic heart failure [New York Heart Association (NYHA) class II/III], with iron deficiency [defined as ferritin <100 ng/mL, or ferritin 100-300 ng/mL if transferrin saturation (TSAT) <20%] and haemoglobin (Hb) < 15 g/dL. Patients were randomized 1:1:1 to treatment into three arms: a first group treated with intravenous iron supplementation, a second treated by intramuscular iron supplementation and the third one which have received placebo. These patients were followed-up during a period of 04 weeks.
The aim of this study is to assess the short term effect of parenteral iron supplementation on exercise tolerance and oxidative stress in patients with stable chronic heart failure and iron deficiency in a sub-Saharan Africa. In addition, it will also try to evaluate its effectiveness using the intramuscular route and this with a simplified administration scheme.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Iron sucrose IV arm | Active Comparator | Perfusion of diluted iron sucrose i.v. in two weeks. Half of the total dose at Day 0 and the other half at Day 14 |
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| Ferric polymaltose hydroxide complex IM arm | Active Comparator | Injection in two series, begin at Day 0 and the second at Day 14. In each series, we administered 300 mg of iron IM until reach half of the dose |
|
| Placebo arm | Placebo Comparator | 100 ml i.v. of normal saline administered at Day 0 and at day 14. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Iron Sucrose IV | Drug | Intervention will consisted of the administration for the IV route. -The IV route in two doses will be diluted bolus injection of iron or normal saline at day 0 and day 14. |
| Measure | Description | Time Frame |
|---|---|---|
| Variation in 6-minute walk test (6MWT) distance | Variation in 6MWT in meter distance from the baseline to week 4. By using pedometer | 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in quality of life assessed by the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) | Minnesota Living With Heart Failure Questionnaire score at Week 4 adjusted for baseline | 4 weeks |
| Change in serum ferritin concentration |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chris Nadege NGANOU-GNINDJIO, MD, MAS | Yaounde Central Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yaounde Central Hospital, Cardiology department | Yaoundé | Cameroon |
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| Ferric polymaltose hydroxide complex IM | Drug | Intervention will consisted of the administration for the IM route. Drug will be given in two series of injection; the first series will began at day 0 and consist of administration of 300 mg of iron per day in intramuscular injection up to the half of the total dose and the second series will began at day 14 for the administration of the other half with the same scheme than the first. |
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|
| Saline solution | Other | 100 ml i.v. of normal saline administered at Day 0 and at day 14. |
|
|
Change in serum ferritin concentration (micromol/l) level from baseline to week 4. By immunology
| 4 weeks |
| Change in serum concentration of anti-oxidant markers: Reduced Glutathione (micromol) | Change in serum concentration of anti-oxidant markers from baseline to week 4. By spectrophotometer | 4 weeks |
| Change in serum concentration of oxidant marker: Malondialdehyde (micromol/l) | Change in concentration of oxidant marker from baseline to week 4. By spectrophotometer | 4 weeks |
| Change in Left Ventricle Ejection Fraction by Simpson method | Change in Left Ventricle Ejection Fraction (%) by Simpson method on echocardiography from baseline to week 4 | 4 weeks |
| Cost-effectiveness by using the Incremental Cost-effectiveness Ratio (ICER) | Cost-effectiveness by using the ICER questionnaire between the IV and the IM route | 4 weeks |
| Standard safety assessments | Standard safety assessments: adverse events by questionnaires | 4 weeks |
| ID | Term |
|---|---|
| D000090463 | Iron Deficiencies |
| ID | Term |
|---|---|
| D019189 | Iron Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D000077605 | Ferric Oxide, Saccharated |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D005290 | Ferric Compounds |
| D058085 | Iron Compounds |
| D007287 | Inorganic Chemicals |
| D005937 | Glucaric Acid |
| D013400 | Sugar Acids |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D006880 | Hydroxy Acids |
| D002241 | Carbohydrates |
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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