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Iron-deficiencyPhase 3EFFECT-KTxNCT03769441

Effect of Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation

A Phase 3 study testing Ferric carboxymaltose and Sodium chloride in people with Iron-deficiency and Transplant-Related Disorder, run by University Medical Center Groningen at 2 sites in Netherlands.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Iron deficiency is common in kidney transplant recipients and is associated with impaired exercise tolerance and an unfavourable prognosis. This multicentre double-blind, placebo-controlled randomized controlled clinical trial will allow the investigators to analyse the effects of intravenous iron correction with… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Iron-deficiency, Transplant-Related Disorder
What is being tested?
Ferric carboxymaltose and Sodium chloride
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
148 participants
Where
2 sitesNetherlands
Study dates
2 Aug 2019to 19 Aug 2024
Phase
Phase 3
Are there results?
None posted in the registry

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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Kidney transplant recipient
  • Iron deficiency, defined by a ferritin level of ≤100 ug/L, or 100-299 ug/L combined with a transferrin saturation of ≤20%
  • At least six months after transplantation at baseline
  • Age ≥18 years
  • Ability to comply with the study protocol
  • Informed consent

Who cannot join

  • Intolerance to any intravenous iron solution
  • Severe anemia (Hb <10.5 g/dL, <6.5 mmol/L), microcytic anemia (MCV <80 fl) or progressive anemia (˃3.2 g/dL per month decline for two months or more)
  • A positive feces occult blood test or otherwise demonstrated gastrointestinal, or urogenital, blood loss
  • Blood transfusion in the past six weeks
  • Polycythemia (Hb >15.3 g/dL, 9.5 mmol/L)
  • Estimated glomerular filtration rate (eGFR) of ≤ 30 ml/min per 1.73 m2
Show all 13Show fewer
  • History of haemochromatosis
  • Unstable angina or myocardial infarction during the previous month
  • Disability to walk
  • Severe hypophosphatemia in the month before baseline (serum phosphate <0.35 mmol/L)
  • Pregnancy or inability to take adequate contraceptive measures when at childbearing age (women)
  • Any signs of an active systemic infection
  • Participation in another interventional study

Trial locations and contacts

2 sites in 1 country.

Netherlands2 sites
  • University Medical Center Groningen

    Groningen, 9713 GZ

  • University Medical Center Utrecht

    Utrecht

Other trials in Netherlands

About this study

Official title: Effect of Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation: a Multicenter Randomized Controlled Trial

Iron deficiency is common in kidney transplant recipients and is associated with impaired exercise tolerance and an unfavourable prognosis.

This multicentre double-blind, placebo-controlled randomized controlled clinical trial will allow the investigators to analyse the effects of intravenous iron correction with ferric(III) carboxymaltose on exercise tolerance and other parameters, in comparison to a placebo.

Read the detailed description

Rationale: Iron deficiency is common in kidney transplant recipients. The presence of iron deficiency is associated with an unfavourable prognosis in these patients. In patients with heart failure and iron deficiency, treatment with intravenous iron improved exercise capacity and quality of life. Whether such beneficial effects may also occur in kidney transplant recipients is unknown.

Objective: Our main objective is to address whether correction of iron deficiency with ferric(III) carboxymaltose improves exercise tolerance and quality of life in iron-deficient kidney-transplant recipients.

Study design: A multicentre double-blind, placebo-controlled randomized controlled clinical trial will be performed to compare the effects of ferric(III) carboxymaltose with placebo.

Study population: 158 iron-deficient kidney transplant recipients. The intervention arm will receive 10 mL of ferric(III) carboxymaltose (50 mg Fe3/mL, intravenously) every six weeks, with a total of four dosages. The control arm receives an intravenous placebo solution (saline).

Main study parameters/endpoints: The primary endpoint is the distance walked in six minutes, as quantified by the six-minute-walking-test at the end of follow-up.

The investigators expect that iron-deficient kidney transplant recipients will benefit from ferric(III) carboxymaltose treatment as a result of an improvement in exercise tolerance and general wellbeing.

Being tested
Ferric carboxymaltose, Sodium chloride
Keywords
Renal Transplantation, Kidney Transplantation, Iron Deficiency
Medical subject headings
Anemia, Iron-Deficiency, Iron Deficiencies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ferric carboxymaltoseDrug

    Four intravenous dosages of ferric(III) carboxymaltose

  • Sodium chlorideDrug

    Also called Placebo

    Four intravenous dosages of sodiumchloride

Study groups in NCT03769441
Study groupRoleWhat they receive
Ferric(III) carboxymaltoseActive comparatorThe intervention group will be treated with four dosages of 500 mg iron in the form of 10 mL ferric(III) carboxymaltose dissolved in 240 mL of NaCl 0.9%, with interval periods of six weeks.
Receives: Drug: Ferric carboxymaltose
PlaceboPlacebo comparatorThe placebo-controlled group will receive four dosages of 250 mL of NaCl 0.9% solution with interval periods of six weeks.
Receives: Drug: Sodium chloride

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Exercise tolerance

    The between-group difference in change in exercise tolerance quantified by the six-minute walk test (6MWT)

    Measured: 24 weeks

Secondary outcomes (40)
  1. Hemoglobin level

    The between-group difference in change in hemoglobin level

    Measured: 24 weeks

  2. Iron status

    The between-group difference in change in iron parameters (plasma iron, ferritin, transferrin saturation)

    Measured: 24 weeks

  3. Cardiac function

    The between-group difference in change in cardiac structure, function and strain, analysed with a transthoracic echocardiography

    Measured: 24 weeks

  4. Muscle strength 1

    The between-group difference in change in muscle strength measured by the 'Five-Times-Sit-to-Stand-test (FTSTS)

    Measured: 24 weeks

  5. Muscle strength 2

    The between-group difference in change in muscle strength measured by the timed-up-and-Go test (TUG)

    Measured: 24 weeks

  6. Muscle strength 3

    The between-group difference in change in muscle strength measured by handgrip dynamometry

    Measured: 24 weeks

  7. Muscle mass

    The between-group difference in change in muscle mass assessed using 24-hour urinary creatinine excretion

    Measured: 24 weeks

  8. Phosphate level

    The between-group difference in change in phosphate level

    Measured: 24 weeks

  9. Calcium level

    The between-group difference in change in calcium level

    Measured: 24 weeks

  10. Vitamin D status

    The between-group difference in change in vitamin D level

    Measured: 24 weeks

  11. Parathyroid hormone

    The between-group difference in change in parathyroid hormone level level

    Measured: 24 weeks

  12. FGF23

    The between-group difference in change in FGF23 level

    Measured: 24 weeks

  13. Intestinal microbiota

    The between-group difference in change in intestinal microbiota

    Measured: 24 weeks

  14. Incidence of any infection

    The between-group difference in incidence of infections

    Measured: 24 weeks

  15. Incidence of hospitalisation

    The between-group difference in incidence of hospitalisation

    Measured: 24 weeks

  16. Incidence of cardiac events

    The between-group difference in incidence of cardiac events

    Measured: 24 weeks

  17. Incidence of graft failure

    The between-group difference in incidence of graft failure

    Measured: 24 weeks

  18. Lymphocyte production of cytokines

    The between-group difference in lymphocyte cytokine espression (measured with facs)

    Measured: 24 weeks

  19. Lymphocyte production of immunoglobulins

    The between-group difference in lymphocyte IgG production (measured with ELISA)

    Measured: 24 weeks

  20. Lymphocyte proliferation rate

    The between-group difference in lymphocyte proliferation rate (assessed with FACS)

    Measured: 24 weeks

  21. B-lymphocyte differentiation rate

    The between-group difference in B-lymphocyte plasma cell formation (assessed with Facs)

    Measured: 24 weeks

  22. Cognitive performance (memory span)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Digit Span Forward Test, minimum value 0, maximum value 9, a higher score means a better outcome)

    Measured: 24 weeks

  23. Cognitive performance (verbal memory)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (15 word test, minimum value 0, maximum value 75, a higher score means a better outcome)

    Measured: 24 weeks

  24. Cognitive performance (semantic memory)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Word Fluency Test, minimum value 0, no maximum value, a higher score means a better outcome)

    Measured: 24 weeks

  25. Cognitive performance (processing speed)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (symbol digit modalities test, minimum value 0, maximum value 110, a higher score means a better outcome)

    Measured: 24 weeks

  26. Cognitive performance (visuomotor and mental speed)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Trail Making Test A, minimum value 1, no maximum value, a lower score means a better outcome)

    Measured: 24 weeks

  27. Cognitive performance (cognitive flexibility)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Trail Making Test B, minimum value 1, no maximum value, a lower score means a better outcome)

    Measured: 24 weeks

  28. Cognitive performance (executive control)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Controlled Oral Word Association Test, minimum score 1, no maximum score, a higher score means a better outcome)

    Measured: 24 weeks

  29. Cognitive performance (working memory)

    The between-group difference in change in cognitive performance quantified with neuropsychological testing (Digit Span Backward, minimum score 0, maximum score 8, a higher score means a better outcome)

    Measured: 24 weeks

  30. Plasma creatinine

    The between-group difference in change in plasma creatinine

    Measured: 24 weeks

  31. Quality of Life (health)

    The between-group difference in change in quality of life quantified with SF36 questionnaire. A higher score means a better outcome.

    Measured: 24 weeks

  32. Quality of Life (subjective fatigue)

    The between-group difference in change in quality of life quantified with the Dutch Checklist individual Strength). A higher score means worse fatigue.

    Measured: 24 weeks

  33. Quality of Life (long-lasting fatigue)

    The between-group difference in change in quality of life quantified with the Dutch Multifactor Fatigue Scale). A higher score means worse fatigue.

    Measured: 24 weeks

  34. Quality of Life (overall)

    The between-group difference in change in quality of life quantified with EuroQol-5D-5L

    Measured: 24 weeks

  35. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccination IgG response

    The between-group difference in severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) specific antibody titre after vaccination.

    Measured: 12 months

  36. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccination T-lymphocyte response

    The between-group difference in severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) specif T-lymphocyte response after vaccination.

    Measured: 12 months

  37. Gastro-intestinal symptoms

    The between-group difference in change in gastro-intestinal symptoms assessed with the gastrointestinal symptom rating scale.

    Measured: 24 weeks

  38. Hepatic injury

    The between-group difference in change in plasma hepatic enzyme levels (aspartate transaminase and alanine transaminase)

    Measured: 24 weeks

  39. Restless legs

    The between-group difference in prevalence of restless legs symptoms before and after treatment

    Measured: 24 weeks

  40. Kidney graft rejection and injury

    The between-group difference in change in urine kidney injury marker levels

    Measured: 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Dec 2018
  2. Study start2 Aug 2019
  3. Primary completion19 Aug 2024
  4. Study completion19 Aug 2024

Resources

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
Parallel groups
Model description
The study is designed as a 24 week, multicentre, randomized placebo-controlled clinical trial with two parallel arms to investigate the effect of ferric(III) carboxymaltose on exercise tolerance, cardiac function, skeletal muscle function, quality of life, the gut microbiota and on the immune system, to be performed at the University Medical Center Groningen (UMCG) and the Erasmus MC, University Medical Center Rotterdam.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
148 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03769441
Sponsor's protocol ID
201800450
Acronym
EFFECT-KTx
Status last verified
Aug 2024
First submitted
3 Dec 2018
Last updated
27 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: To protect participant privacy, public access to the dataset or individual participant data will not be provided. However, after deidentification of these data and after publication of the main results, requests for the re-use of all pseudo-anonymised individual participant data by researchers who provide a methodologically sound proposal for a secondary analysis or meta-analysis will be evaluated by the Principal Investigator. Data may be shared if the research question falls within the scope of the informed consent. Proposals should be directed to m.h.de.borst@umcg.nl and requestors will need to sign a data access agreement.

Publications

  • Vinke JSJ, Eisenga MF, van der Vaart A, van Lieshout CJ, Dolmans HWGM, van der Meer P, Ter Maaten JM, Spikman JM, Ziengs AL, Kootstra-Ros JE, Nolte IM, Gaillard CGM, de Jong MFC, Berger SP, Sanders JF, Bakker SJL, van Zuilen AD, de Borst MH. Intravenous ferric carboxymaltose and exercise capacity in iron-deficient kidney transplant recipients: a randomised, placebo-controlled trial in the Netherlands. EClinicalMedicine. 2026 Sep 1;99:104169. doi: 10.1016/j.eclinm.2026.104169. eCollection 2026 Sep.

    PubMed 42733564
  • Vinke JS, Eisenga MF, Sanders JF, Berger SP, Spikman JM, Abdulahad WH, Bakker SJ, Gaillard CAJM, van Zuilen AD, van der Meer P, de Borst MH. Effect of Intravenous Ferric Carboxymaltose on Exercise Capacity After Kidney Transplantation (EFFECT-KTx): rationale and study protocol for a double-blind, randomised, placebo-controlled trial. BMJ Open. 2023 Mar 22;13(3):e065423. doi: 10.1136/bmjopen-2022-065423.

    PubMed 36948568

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ferric carboxymaltose and Sodium chloride in people with Iron-deficiency and Transplant-Related Disorder, run by University Medical Center Groningen at 2 sites in Netherlands.

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 6 inclusion and 13 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 27 Aug 2024. 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 Netherlands. 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. Some participants in this study may receive a placebo. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Exercise tolerance (time frame: 24 weeks). 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 NCT03769441, 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 27 Aug 2024.

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