AnemiaPhase 3DEODONCT03725384
Daily vs. Every Other Day Oral Iron Supplementation in Patients With Absolute Iron Deficiency Anemia
A Phase 3 study testing Ferrous Sulfate 300Mg Tablet and Vitamin C 500Mg tablet in people with Anemia and Iron Deficiency Anemia, run by Sunnybrook Health Sciences Centre at 2 sites in Canada.
Trial summary
Iron deficiency anemia is a global health problem and the most common cause of anemia worldwide. Patients with iron deficiency (ID) and IDA can present with a multitude of symptoms including fatigue, restless legs syndrome and pica.Oral iron supplementation is associated with increasing hemoglobin in multiple studies… Read more about this study
- Who is it for?
- Ages 16 years and older
- Conditions the study is for
- Anemia, Iron Deficiency Anemia
- What is being tested?
- Ferrous Sulfate 300Mg Tablet and Vitamin C 500Mg tablet
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 51 participants
- Where
- 2 sitesCanada
- Study dates
- 4 Jan 2019to 26 Jan 2022
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 16 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age ≥ 16 years;
- Outpatients with iron deficiency anemia defined as Hb less than 120 g/L in women or 130g/L in men; AND ferritin less than 30 mcg/L
Who cannot join
- • Pregnancy
- Currently breastfeeding
- Known history of inflammatory bowel disease
- Known history of celiac disease
- Known history of thalassemia or thalassemia trait
- Known inherited bleeding disorder
Show all 19Show fewer
- Known intolerance or lack of response to oral ferrous gluconate, sulfate or fumarate in the last 12 weeks
- Multivitamin and mineral supplements (35 mg or more of elemental iron per day) in the 2 weeks prior to randomization
- Allergy to oral iron
- Allergy to any of the following medicinal and non-medicinal ingredients in ferrous sulfate: ferrous sulphate, calcium citrate, crospovidone, FD\&C Red #40-Aluminum lake, FD\&C Yellow #6-Aluminum Lake, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polyvinyl alcohol, purified water, talc titanium dioxide
- Allergy to any of the following medicinal and non-medicinal ingredients in vitamin C: Ascorbic acid, Colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, microcrystalline cellulose and stearic acid
- Intravenous iron therapy in the past 12 weeks
- On anticoagulant therapy (e.g. warfarin, apixaban, dabigatran, edoxaban, rivaroxaban) initiated in the past 6 months
- Surgery planned in upcoming 12 weeks
- Chemotherapy planned in upcoming 12 weeks
- Blood donation planned in upcoming 12 weeks
- Previously enrolled in the study
- Creatinine clearance less than 30 mL/min
- Hemoglobin less than 80 g/L with active bleeding (defined as WHO grade 2 bleeding or higher in the past week)
Trial locations and contacts
2 sites in 1 country.
Canada2 sites
Sunnybrook Health Sciences Centre
Toronto, Ontario, M4N 3M5
St. Michael's Hospital
Toronto, Ontario, M5B 1W8
About this study
Official title: Daily vs. Every Other Day Oral Iron Supplementation in Patients With Absolute Iron Deficiency Anemia (DEODO): a Multi-centered, Pilot Randomized Controlled Trial
Iron deficiency anemia is a global health problem and the most common cause of anemia worldwide. Patients with iron deficiency (ID) and IDA can present with a multitude of symptoms including fatigue, restless legs syndrome and pica.Oral iron supplementation is associated with increasing hemoglobin in multiple studies in women, pregnant women and elderly patients.However, the optimal dose and frequency of oral iron supplementation for treatment remains unclear. The current proposed study attempts to address this gap in the literature.
Read the detailed description
This is a pilot, pragmatic, non-inferiority, open label randomized controlled trial (RCT) in outpatients with iron deficiency anemia to evaluate the effectiveness of oral ferrous sulfate 300mg (60mg elemental iron) once daily versus every other day to improve hemoglobin at 12 weeks post-initiation. The rationale for this study includes: (1) IDA is a common and prevalent condition with potential adverse consequences if left untreated; (2) optimizing effectiveness of oral iron supplementation while minimizing side effects will improve treatment for patients.
Because IDA is a global health problem, common in clinical practice and treatable, this study will have a significant practical impact on how clinicians treat outpatients with iron deficiency anemia and how patients tolerate therapy.
For the patient, the expected benefit from taking part in this study is the potential to improve and treat iron deficiency anemia. These potential changes may lead to improved symptoms associated with iron deficiency anemia, such as cognitive and physical functioning, and fatigue.
- Conditions
- Anemia, Iron Deficiency Anemia
- Being tested
- Ferrous Sulfate 300Mg Tablet, Vitamin C 500Mg tablet
- Keywords
- Anemia, Iron deficiency, hemoglobin, oral iron, Ferrous sulfate
- Medical subject headings
- Anemia, Anemia, Iron-Deficiency, Iron Deficiencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ferrous Sulfate 300Mg TabletDrug
Also called Iron, Oral iron
oral dose of Ferrous Sulfate (300 mg) every day versus every other day along with vitamin C
Vitamin C 500Mg tabletDrug
Also called Ascorbic acid
Vitamin C 500 Mg tablet every day versus every other day along with ferrous sulfate
| Study group | Role | What they receive |
|---|---|---|
| Ferrous Sulfate and Vitamin C every other day | Experimental | Ferrous sulfate 300mg tablet and vitamin C 500mg tablet taken by mouth every other day for 12 weeks Receives: Drug: Ferrous Sulfate 300Mg Tablet; Drug: Vitamin C 500Mg tablet |
| Ferrous Sulfate and Vitamin C daily | Active comparator | Ferrous sulfate 300mg tablet and vitamin C 500mg tablet taken by mouth every day for 12 weeks Receives: Drug: Ferrous Sulfate 300Mg Tablet; Drug: Vitamin C 500Mg tablet |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feasibility of Enrolling Patients in the Trial
Enrollment in the trial will be defined as documentation of informed consent for patients approached. The primary outcome of this study is the feasibility of enrolling 52 participants in the trial over a 2-year period. Eligibility based on lab criteria was determined after consent.
Measured: 2 years
Secondary outcomes (19)
Proportion of Eligible Participants Consenting
Proportion of eligible patients after initial inclusion/exclusion screening that consent to participating in the study. Eligibility based on lab criteria was determined after consent.
Measured: 2 years
Proportion of Patients Receiving the Allocated Treatment
Proportion of patients who signed informed consent and received the allocated treatment they were randomly assigned to.
Measured: 2 years
Proportion of Patients Completing Laboratory Tests
Proportion of treated patients who completed both 4 week and 12 week laboratory tests
Measured: 2 years
Proportion of Treated Patients Completing Side Effect Questionnaire at Week 4, 8 and 12
Proportion of treated patients completing 4 week, 8 week and 12 week side effect questionnaire
Measured: 2 years
Proportion of Patients Completing FACIT-fatigue Scale
Proportion of patients who received treatment and completed 4 week, 8 week and 12 week FACIT-fatigue scale
Measured: 2 years
Adherence to Treatment
Adherence was measured by the proportion of treated patients who took at least 90% of their prescribed doses
Measured: 2 years
Proportion of Treated Patients Requiring a Step Down in Therapy
Proportion of treated patients requiring a step down in therapy by Week 4 and Week 12 (same proportions at both time points).
Measured: 2 years
Hemoglobin Increment
Hemoglobin increment at 4 and 12 weeks is defined as the 4 or 12 week hemoglobin value minus the baseline hemoglobin value
Measured: 12 weeks
Proportion With Complete Hemoglobin Response
Proportion with complete hemoglobin response defined as hemoglobin greater than or equal to 120 g/L in women; and 130 g/L in men at 4 weeks and 12 weeks
Measured: 2 years
Reticulocyte Count
Change in reticulocyte count at 4 and 12 weeks defined as the 4 or 12 week reticulocyte count minus the baseline reticulocyte count
Measured: 12 weeks
Change in Ferritin at 12 Weeks
Change in ferritin at 12 weeks, defined as the value at 12 weeks minus the baseline value.
Measured: 12 weeks
Change in Serum Iron at 12 Weeks
Change in serum iron at 12 weeks defined as the value at 12 weeks minus the baseline value
Measured: 12 weeks
Change in TSAT at 12 Weeks
Change in transferrin saturation (TSAT) at 12 weeks defined as the value at 12 weeks minus the baseline value. Interquartile range represents Q1 (25th percentile) to Q3 (75th percentile)
Measured: 12 weeks
FACIT-fatigue Score at 4, 8 and 12 Weeks
Quality of life (FACIT-fatigue scale) at 4, 8 and 12 weeks. Functional Assessment of Chronic Illness Therapy (FACIT) - fatigue scale.
On this scale, lower scores indicate better symptoms and higher scores represent worse symptoms. The FACIT-fatigue scale has a range from 0 to 52.
Measured: 12 weeks
Proportion of Patients With Side Effects at 4, 8 and 12 Weeks
Proportion of patients with side effects at 4, 8 and 12 weeks, as determined by the oral iron side effect questionnaire
Measured: 12 weeks
Proportion of Patients Who Stopped Oral Iron Due to Side Effects
Number of patients who discontinued oral iron therapy due to side effects by week 12.
Measured: 12 weeks
Number of Patients in Need of Escalation Therapy
Need for escalation in therapy (increase in oral iron regimen from every other day to daily, need for intravenous iron, need for transfusion, visit to emergency department related to anemia) assessed at 12 weeks
Measured: 2 years
Proportion of Patients With a Drop in Hemoglobin at Weeks 4 and 12
Proportion of patients with a drop in hemoglobin of 10 g/L or more at weeks 4 and 12
Measured: 2 years
Types of Adverse Effects at 4 Weeks
Proportion of patients with each type of adverse event at week 4.
Measured: 4 Weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted31 Oct 2018
- Study start4 Jan 2019
- Primary completion26 Jan 2022
- Study completion26 Jan 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for AnemiaStudies of the same condition, open and under way.
- More trials run by Sunnybrook Health Sciences CentreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 51 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sunnybrook Health Sciences Centre
- Sponsor type
- University, hospital or other
- Collaborators
- Unity Health Toronto
- Responsible party
- Sponsor
- Investigators
- Dr.Yulia Lin, Principal investigator, Sunnybrook Health Sciences Centre
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03725384
- Sponsor's protocol ID
- CTO ID 1534
- Acronym
- DEODO
- Status last verified
- May 2024
- First submitted
- 23 Oct 2018
- Last updated
- 3 Feb 2025
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Kron A, Del Giudice ME, Sholzberg M, Callum J, Cserti-Gazdewich C, Swarup V, Huang M, Distefano L, Anani W, Skeate R, Armali C, Lin Y. Daily versus every other day oral iron supplementation in patients with iron deficiency anemia (DEODO): study protocol for a phase 3 multicentered, pragmatic, open-label, pilot randomized controlled trial. Pilot Feasibility Stud. 2022 May 4;8(1):98. doi: 10.1186/s40814-022-01042-y.
PubMed 35509085Lin Y, Del Giudice ME, Kron A, Meirovich H, Sholzberg M, Swarup V, Huang M, Distefano L, Anani WQ, Armali C, Bussel JB, Callum J. A pilot feasibility trial of daily versus every other day oral iron supplementation in patients with iron deficiency anaemia. Br J Haematol. 2023 Jun;201(5):1000-1004. doi: 10.1111/bjh.18792. Epub 2023 Mar 31. No abstract available.
PubMed 36999886
Study at a glance
From the registry record, last updated by the sponsor on 3 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Daily vs. Every Other Day Oral Iron Supplementation in Patients With Absolute Iron Deficiency Anemia (DEODO): a Multi-centered, Pilot Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT03725384
- Acronym / sponsor ID
- DEODO / CTO ID 1534
- Conditions
- Anemia, Iron Deficiency Anemia
- Keywords
- Anemia, Iron deficiency, hemoglobin, oral iron, Ferrous sulfate
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 51 participants (actual)
- Lead sponsor
- Sunnybrook Health Sciences CentreUniversity, hospital or other
- Collaborators
- Unity Health Toronto
- Study start
- 4 Jan 2019 (actual)
- Primary completion
- 26 Jan 2022 (actual)
- Study completion
- 26 Jan 2022 (actual)
- First posted
- 31 Oct 2018 (actual)
- Results
- Posted 3 Feb 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Iron deficiency anemia is a global health problem and the most common cause of anemia worldwide. Patients with iron deficiency (ID) and IDA can present with a multitude of symptoms including fatigue, restless legs syndrome and pica.Oral iron supplementation is associated with increasing hemoglobin in multiple studies in women, pregnant women and elderly patients.However, the optimal dose and frequency of oral iron supplementation for treatment remains unclear. The current proposed study attempts to address this gap in the literature.
Detailed description
This is a pilot, pragmatic, non-inferiority, open label randomized controlled trial (RCT) in outpatients with iron deficiency anemia to evaluate the effectiveness of oral ferrous sulfate 300mg (60mg elemental iron) once daily versus every other day to improve hemoglobin at 12 weeks post-initiation. The rationale for this study includes: (1) IDA is a common and prevalent condition with potential adverse consequences if left untreated; (2) optimizing effectiveness of oral iron supplementation while minimizing side effects will improve treatment for patients.
Because IDA is a global health problem, common in clinical practice and treatable, this study will have a significant practical impact on how clinicians treat outpatients with iron deficiency anemia and how patients tolerate therapy.
For the patient, the expected benefit from taking part in this study is the potential to improve and treat iron deficiency anemia. These potential changes may lead to improved symptoms associated with iron deficiency anemia, such as cognitive and physical functioning, and fatigue.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Ferrous Sulfate and Vitamin C every other day | Experimental | Drug: Ferrous Sulfate 300Mg Tablet, Drug: Vitamin C 500Mg tabletFerrous sulfate 300mg tablet and vitamin C 500mg tablet taken by mouth every other day for 12 weeks |
| Ferrous Sulfate and Vitamin C daily | Active comparator | Drug: Ferrous Sulfate 300Mg Tablet, Drug: Vitamin C 500Mg tabletFerrous sulfate 300mg tablet and vitamin C 500mg tablet taken by mouth every day for 12 weeks |
Who may qualify
- Ages
- 16 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (2 listed)
- Age ≥ 16 years;
- Outpatients with iron deficiency anemia defined as Hb less than 120 g/L in women or 130g/L in men; AND ferritin less than 30 mcg/L
Key exclusion criteria (19 listed)
- • Pregnancy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ferrous Sulfate 300Mg TabletAlso: Iron, Oral ironoral dose of Ferrous Sulfate (300 mg) every day versus every other day along with vitamin C | Drug | Ferrous Sulfate and Vitamin C daily, Ferrous Sulfate and Vitamin C every other day |
| Vitamin C 500Mg tabletAlso: Ascorbic acidVitamin C 500 Mg tablet every day versus every other day along with ferrous sulfate | Drug | Ferrous Sulfate and Vitamin C daily, Ferrous Sulfate and Vitamin C every other day |
Primary outcome
Feasibility of Enrolling Patients in the Trial
Time frame: 2 years
Enrollment in the trial will be defined as documentation of informed consent for patients approached. The primary outcome of this study is the feasibility of enrolling 52 participants in the trial over a 2-year period. Eligibility based on lab criteria was determined after consent.
19 secondary outcomes
Proportion of Eligible Participants Consenting
Time frame: 2 years
Proportion of Patients Receiving the Allocated Treatment
Time frame: 2 years
Proportion of Patients Completing Laboratory Tests
Time frame: 2 years
Proportion of Treated Patients Completing Side Effect Questionnaire at Week 4, 8 and 12
Time frame: 2 years
Proportion of Patients Completing FACIT-fatigue Scale
Time frame: 2 years
Adherence to Treatment
Time frame: 2 years
Proportion of Treated Patients Requiring a Step Down in Therapy
Time frame: 2 years
Hemoglobin Increment
Time frame: 12 weeks
Proportion With Complete Hemoglobin Response
Time frame: 2 years
Reticulocyte Count
Time frame: 12 weeks
Change in Ferritin at 12 Weeks
Time frame: 12 weeks
Change in Serum Iron at 12 Weeks
Time frame: 12 weeks
Change in TSAT at 12 Weeks
Time frame: 12 weeks
FACIT-fatigue Score at 4, 8 and 12 Weeks
Time frame: 12 weeks
Proportion of Patients With Side Effects at 4, 8 and 12 Weeks
Time frame: 12 weeks
Proportion of Patients Who Stopped Oral Iron Due to Side Effects
Time frame: 12 weeks
Number of Patients in Need of Escalation Therapy
Time frame: 2 years
Proportion of Patients With a Drop in Hemoglobin at Weeks 4 and 12
Time frame: 2 years
Types of Adverse Effects at 4 Weeks
Time frame: 4 Weeks
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Feb 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 35509085Kron A, Del Giudice ME, Sholzberg M, Callum J, Cserti-Gazdewich C, Swarup V, Huang M, Distefano L, Anani W, Skeate R, Armali C, Lin Y. Daily versus every other day oral iron supplementation in patients with iron deficiency anemia (DEODO): study protocol for a phase 3 multicentered, pragmatic, open-label, pilot randomized controlled trial. Pilot Feasibility Stud. 2022 May 4;8(1):98. doi: 10.1186/s40814-022-01042-y.
- Background: PubMed 36999886Lin Y, Del Giudice ME, Kron A, Meirovich H, Sholzberg M, Swarup V, Huang M, Distefano L, Anani WQ, Armali C, Bussel JB, Callum J. A pilot feasibility trial of daily versus every other day oral iron supplementation in patients with iron deficiency anaemia. Br J Haematol. 2023 Jun;201(5):1000-1004. doi: 10.1111/bjh.18792. Epub 2023 Mar 31. No abstract available.
- Final manuscript - letter to the editorLink provided by the sponsor.
- Study protocolLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Dr.Yulia Lin principal investigator
Sunnybrook Health Sciences Centre
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ferrous Sulfate 300Mg Tablet and Vitamin C 500Mg tablet in people with Anemia and Iron Deficiency Anemia, run by Sunnybrook Health Sciences Centre at 2 sites in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 3 Feb 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Feasibility of Enrolling Patients in the Trial (time frame: 2 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03725384, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Feb 2025.