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CompletedNCT03231085IRON KIDUpdated Dec 30, 2024

Comparison of the Rate of Preoperative Haemoglobin After Administration of Epoetin Alpha Associated With an Oral Medical Supplementation Versus Intravenous Before Surgery of Craniosynostosis at the Child

An interventional study of Ferrous fumarate or ferrostrane in Craniosynostosis, sponsored by University Hospital, Montpellier. Completed at 2 sites in France. Open to participants aged 4 Months to 24 Months. Per ClinicalTrials.gov, last updated 2024-12-30.

Sponsored by University Hospital, Montpellier · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
4 Months to 24 Months
Sex
All
01

Study summary

Oral iron is commonly used in conjunction with EPO preoperatively for hemorrhagic surgeries in children and especially in the surgery of craniosynostosis. The bioavailability of oral iron is low and compliance with treatment is inconsistent. The aim of this study is to evaluate whether the use of ferric carboxymaltose by injection, which has a much better bioavailability, would make it possible to increase the preoperative hemoglobin level more effectively and thus reduce the risk of perioperative blood transfusion .

Read the detailed description

Prospective study, randomized in two parallel groups (martial treatment versus venous injection) and stratified by center (Montpellier, Nice, Angers).

The number of subjects required is 100 patients, or 50 per group.

02

Conditions studied

  • Craniosynostosis

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Keywords

  • Craniosynostosis
  • hemoglobin
  • iron peros
  • iron intravenous
03

Who can participate

Ages eligible
4 Months to 24 Months
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Craniosynostosis Surgery
  • Age: between 4 and 24 months inclusive
  • Weight: less than 12kg
  • Hemoglobin: 10 g / dl ≤ Hb 14 ≤ g / dl
  • Affiliated patients or beneficiaries of a Social Security scheme
  • Signature of the consent of the patient's parents

Exclusion criteria

Exclusion Criteria:

  • Generalized infection
  • Time for consultation of anesthesia with respect to the date of surgery greater than 5 weeks or less than 22 days.
  • Initial biological assessment dating more than 3 months before the consultation of anesthesia
  • Parents do not understand French
  • BMI greater than 20 kg.m-2
  • Contraindications to EPO
  • Contraindications to ferric carboxymaltose and to ferrous fumarate
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Care provider)
Enrollment
100 participants (actual)

Study arms

  • Active comparator
    Ferrous fumarate or ferrostrane

    The oral treatment should begin 21 days before surgery. Recommended Dosage ferrous fumarate according to the SPC in force: * 5 to 8 kg: 2 cd rases / d or 200mg of ferrous fumarate * 8 to 10 kg: 3 cd rases / d or 300mg of ferrous fumarate * 10 to 12kg: 4 cd rases / d or 400mg of ferrous fumarate Ferrostrane ® (syrup) Laboratory TEOFARMA SRL Either 34mg of iron per teaspoon Recommended dosage according to the SPC in force: * Infant 5 to 8 kg (about 1 to 6 months): 2 teaspoons a day, * Infant from 8 to 12 kg (about 6 to 30 months): 3 teaspoons a day.

    Drug: Ferrous fumarate or ferrostrane

  • Experimental
    Ferric carboxymaltose

    The single intravenous treatment the day of the inclusion. Dosage according to: 15mg / kg iron (to dilute in 3 ml / kg of Nacl 0.9% (SSI), to pass in 15 minutes.

    Drug: Ferrous fumarate or ferrostrane

Interventions

  • DrugFerrous fumarate or ferrostrane

    Young children operated with craniosynostosis and treated with EPO and ferrous fumarate or ferostrane per os or intravenous ferric carboxymaltose.

    Also known as: Intravenous ferric carboxymaltose.

05

What researchers measure

Primary outcomes

  1. Variation from reference in hemoglobin rate at the day before surgery

    Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery)

    Time frame: Hemoglobin rate change from reference day (right before treatment) to one day before surgery (from 22 days to 5 weeks maximum)

Secondary outcomes

  1. Variation from reference in hemoglobin rate at the day before surgery depending on the reference iron status

    Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery) depending on the reference iron status

    Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)

  2. Variation from reference in hemoglobin rate at the day before surgery depending on the inflammatory state of patient evaluated by CRP rate before treatment

    Variation of hemoglobin rate between reference value (collected right before the implementation of treatment) and preoperative hemoglobin rate (collected one day before surgery) depending on the CRP rate before treatment

    Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)

  3. Frequency of EPO treatment discontinuation at the end of 2nd injection

    Number of patient stopping EPO injections at the end of 2nd injection

    Time frame: 15 days before surgery

  4. Variation from reference in iron status at the day before surgery

    Changes in iron status between reference day (right before the implementation of treatment) and preoperative iron status (one day before surgery)

    Time frame: Reference day (right before treatment) and one day before surgery (from 22 days to 5 weeks maximum)

  5. Occurrence of adverse events due to experimental treatments

    Comparision of adverse event du to experimental treatments (ferric carboxymaltose versus ferrous fumarate)

    Time frame: from treatment administration to end of patient follow-up

  6. Compliance of oral iron treatment

    Evaluated by visual analogic scale (0 the minimum to 10 the maximum)

    Time frame: At the end of oral iron treatment

  7. Rate of blood transfusion in perioperative phase and during 3 days following surgery

    Number of transfused patients among all patients

    Time frame: Perioperative phase and during 3 days following surgery

  8. Number of packed red blood cells transfused in perioperative phase and during 3 days following

    Time frame: Perioperative phase and during 3 days following surgery

  9. Volume of packed red blood cells transfused

    Volume in mL/kg

    Time frame: Perioperative phase and during 3 days following surgery

  10. Total perioperative blood loss

    Expressed in red blood cell mass

    Time frame: Perioperative phase and during 3 days following surgery

  11. Cost of oral ferrous fumarate treatment compared to ferric carboxymaltose treatment

    Time frame: At the end of patient folllow-up (6 months after surgery)

06

Study locations

2 sites
  • University Hospital of Angers
    Angers, 49100, France
  • University Hospital of Montpellier
    Montpellier, 34295, France
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03231085
Lead sponsor
University Hospital, Montpellier
Responsible party
Sponsor
First posted
Jul 27, 2017
Start date
Oct 31, 2017
Primary completion
Apr 11, 2024
Completion
Oct 3, 2024
Last update
Dec 30, 2024

Study contacts

Philippe PIRAT, MD
principal investigator · Department d'Anesthésie reanimation Lapeyronie

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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