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CompletedNCT05098249Updated May 24, 2023

Ferric Carboxymaltose With or Without Phosphate Substitution for the Treatment of Iron Deficiency or Iron Deficiency Anemia

A Phase 4 interventional study of Verum and Placebo in Anemia, Iron-deficiency and Hypophosphatemia, sponsored by Donat R. Spahn. Completed at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-05-24.

Primary conditionAnemia, Iron-DeficiencyRegistry: AnemiaReclassifiedWhy we changed it
Registry
Anemia — the first condition term the registry derived for this study.
ClinicalTrials.gg
Anemia, Iron-Deficiency
Why
  1. The study's title name Anemia, Iron-Deficiency, a narrower term within Anemia.
Confidence
High: the new condition is named in the study's own title. Of 46 hand-checked studies reclassified this way, 72% were exactly right and 89% in the right disease family; the registry's first term was right for 4% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Donat R. Spahn · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
92
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a confirmatory trial to establish superior serum phosphate stability associated with use of Phoscap® compared with placebo as a supplement for treatment of iron deficiency or iron deficiency anemia with Ferinject® before elective surgery.

Read the detailed description

Iron deficiency anemia is a global health problem most commonly caused by excessive blood loss, impaired intestinal iron absorption, or chronic inflammation. In the perioperative setting, intravenous ferric carboxymaltose allows efficient treatment of preoperative iron deficiency and anemia. Recent studies have implied that ferric carboxymaltose might cause hypophosphatemia. Notably, hypophosphatemia has been associated with less muscle strength, which may influence early post-surgery recovery of patients. Additional oral phosphate supplementation may alleviate this hypophosphatemia.

This is a confirmatory trial to establish superior serum phosphate stability associated with use of Phoscap® compared with placebo as a supplement for treatment of iron deficiency or iron deficiency anemia with Ferinject® before elective surgery.

This is also a confirmatory trial to establish non-inferior efficacy of Phoscap® compared with placebo for the treatment of iron deficiency or iron deficiency anemia with Ferinject®; and to establish superior core muscle strength associated with the use of Phoscap® compared with placebo.

02

Conditions studied

  • Anemia
  • Iron-deficiency
  • Hypophosphatemia

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Keywords

  • iron-deficiency anemia
  • hypophosphatemia
  • elective surgery
  • iron-deficiency
  • preoperative iron substitution
  • phosphate substitution
03

In context

Anemia, Iron-Deficiency Reclassified

600 studies on the registry are indexed under Anemia, Iron-Deficiency; 95 are open to participants now.

This study's enrollment of 92 is close to the median of 100 across 459 interventional studies indexed under Anemia, Iron-Deficiency.

Browse Anemia, Iron-Deficiency studies →

Lead sponsor

Donat R. Spahn is the lead sponsor of 2 studies on the registry; none are open to participants now.

Compared within Anemia, Iron-Deficiency, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Anemia. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • as documented by signature (Appendix 5: Informed Consent Form)
  • Male or female ASA 1 to 3 patients, at least 18 years old
  • Scheduled for an elective major abdominal or thoracic surgery.
  • Patients with isolated iron deficiency (defined as concentration (Hb) > 130 g/l, and plasma Ferritin \< 100 ng/ml or TSAT \< 20%), or iron deficiency anemia (defined as Hb 100-130 g/l, and plasma Ferritin \< 100 ng/ml or TSAT \< 20%).
  • Patients scheduled to be hospitalized ≥ 3 days.

Exclusion criteria

Exclusion Criteria:

  • Patients with known anaphylactic reactions to parenteral iron products. Patients with allergy/ to any contents of Ferinject® or Phoscap®.
  • Patients with iron overload or disturbances in utilization of iron (e.g. haemochromatosis, hemosiderosis).
  • Patients with ≥3 times increase in or alanine aminotransferase as per reference range.
  • Patients with excessive blood loss requiring massive transfusion (≥ 10 more red blood cell units).
  • Patients with known myelodysplastic syndromes.
  • Patients with chronic kidney disease with an estimated \< 30 ml/min or with end-stage renal disease requiring scheduled dialysis.
  • Patients with known urinary tract infections with urea-splitting bacteria.
  • Patients with known diseases influencing phosphate, calcium or vitamin D homeostasis (e.g. Hyperparathyroidism, X-linked hypophosphatemia, renal tubular acidosis).
  • Patients taking medication significantly influencing phosphate, calcium or vitamin D homeostasis (e.g. vitamin D substitution > 800 I.E. per day in the last 4 months, pre-existing phosphate substitution, phosphate binders).
  • Patients with preexisting hypophosphatemia
  • Any patient judged to lack the ability to give or perform the trial assessments (e.g. due to dementia, insufficient knowledge of the German language).
  • Women who are pregnant or breast feeding,
  • Intention to become pregnant during the course of the study,
  • Lack of safe , defined as: Female participants of , not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases (Female participants who are surgically sterilized / hysterectomized or for longer than 2 years are not considered as being of child bearing potential),
  • Known or suspected non-compliance, drug or alcohol abuse.
  • Participation in another study with drug within the 30 days preceding and during the present study.
  • Any patient judged by the Principal Investigator or Sub-Investigator to be inappropriate for the trial for any other reason.
Terms in these criteria, in plain language(9)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
92 participants (actual)

Study arms

  • Experimental
    Verum

    Drug: Verum

  • Placebo comparator
    Placebo

    Drug: Placebo

Interventions

  • DrugVerum

    The participant takes two capsules Phoscap® (3mmol/capsule) orally three times a day over 30 days beginning the day of Ferinject administration.

  • DrugPlacebo

    The participant takes wo capsules Placebo orally three times a day over 30 days beginning the day of Ferinject administration.

06

What researchers measure

Primary outcomes

  1. Establish superior serum phosphate stability

    The primary endpoint is superior serum phosphate stability. The investigators measure perioperative phosphate concentrations in participants during the follow-up visits and compare the results between verum and placebo group.

    Time frame: 3 years

Secondary outcomes

  1. Perioperative hemoglobin concentration

    Mean perioperative Hb of the day of surgery, post-operative day (POD)2 and POD4.

    Time frame: 3 years

  2. Core muscle strength

    Pre- and postoperative assessment of core muscle strength by volitional testing of maximal inspiratory and expiratory pressures.

    Time frame: 3 years

07

Study locations

1 site
  • University Hospital Zurich
    Zurich, 8091, Switzerland
08

References and documents

Publications

  • Munoz M, Gomez-Ramirez S, Campos A, Ruiz J, Liumbruno GM. Pre-operative anaemia: prevalence, consequences and approaches to management. Blood Transfus. 2015 Jul;13(3):370-9. doi: 10.2450/2015.0014-15. Epub 2015 Jun 16. No abstract available. PubMed 26192787 ↗
  • Munoz M, Laso-Morales MJ, Gomez-Ramirez S, Cadellas M, Nunez-Matas MJ, Garcia-Erce JA. Pre-operative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery. Anaesthesia. 2017 Jul;72(7):826-834. doi: 10.1111/anae.13840. Epub 2017 Apr 6. PubMed 28382661 ↗
  • Wolf M, Koch TA, Bregman DB. Effects of iron deficiency anemia and its treatment on fibroblast growth factor 23 and phosphate homeostasis in women. J Bone Miner Res. 2013 Aug;28(8):1793-803. doi: 10.1002/jbmr.1923. PubMed 23505057 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 24, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05098249
Lead sponsor
Donat R. Spahn
Responsible party
Donat R. Spahn (Prof. Dr. med., University of Zurich) — Sponsor-investigator
First posted
Oct 28, 2021
Start date
Nov 11, 2021
Primary completion
May 9, 2023
Completion
May 23, 2023
Last update
May 24, 2023

Study contacts

Donat R Spahn, Prof. Dr.
principal investigator · University of Zurich

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in May 2023. You cannot join it, but the record below documents what was studied.

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