RECRUITING

IRONICA: IRON Repletion In Heart Failure - A Comparison of Oral and IV Approaches

Description

The goal of this clinical trial is to learn which iron treatment works better for adults with congestive heart failure and low iron levels: intravenous (IV) iron given through a vein or oral (PO) iron taken by mouth. Participants must have heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) and a transferrin-saturation (TSAT) level below 20 percent. The main questions the study will answer are: 1. Does IV iron raise walking distance on a 6-minute walk test more than oral iron after 24 weeks? 2. Does IV iron improve symptoms and quality of life more than oral iron? 3. How do the two treatments compare for safety, side effects, and hospital readmissions/ mortality? Researchers will compare IV ferric carboxymaltose with oral ferrous sulfate to see which option helps people feel and function better. What participants will do * Be randomly assigned by (like flipping a coin) to IV iron or oral iron. * Receive either a one-time IV iron infusion (with possible repeat at 12 weeks) or take iron pills twice each day for 24 weeks. * Visit the infusion clinic at 6 weeks for second dose of IV iron if needed. * Visit the clinic at 12 weeks for a follow-up to gather follow-up data including 1. A 6-minute walk test 2. Brief symptom and quality-of-life surveys 3. Blood tests to measure serum iron, ferritin, and transferrin saturation This study will help doctors decide whether IV or oral iron is the safer, more effective way to treat iron deficiency in people with heart failure in our local community.

Study Overview

Study Details

Study overview

The goal of this clinical trial is to learn which iron treatment works better for adults with congestive heart failure and low iron levels: intravenous (IV) iron given through a vein or oral (PO) iron taken by mouth. Participants must have heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) and a transferrin-saturation (TSAT) level below 20 percent. The main questions the study will answer are: 1. Does IV iron raise walking distance on a 6-minute walk test more than oral iron after 24 weeks? 2. Does IV iron improve symptoms and quality of life more than oral iron? 3. How do the two treatments compare for safety, side effects, and hospital readmissions/ mortality? Researchers will compare IV ferric carboxymaltose with oral ferrous sulfate to see which option helps people feel and function better. What participants will do * Be randomly assigned by (like flipping a coin) to IV iron or oral iron. * Receive either a one-time IV iron infusion (with possible repeat at 12 weeks) or take iron pills twice each day for 24 weeks. * Visit the infusion clinic at 6 weeks for second dose of IV iron if needed. * Visit the clinic at 12 weeks for a follow-up to gather follow-up data including 1. A 6-minute walk test 2. Brief symptom and quality-of-life surveys 3. Blood tests to measure serum iron, ferritin, and transferrin saturation This study will help doctors decide whether IV or oral iron is the safer, more effective way to treat iron deficiency in people with heart failure in our local community.

IRONICA: IRON Repletion in Congestive Heart Failure - A Randomized Controlled Trial Comparing Oral Versus IV Approaches

IRONICA: IRON Repletion In Heart Failure - A Comparison of Oral and IV Approaches

Condition
Heart Failure
Intervention / Treatment

-

Contacts and Locations

Bowling Green

The Medical Center, Bowling Green, Kentucky, United States, 42101

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Age ≥18 years
  • * BMI ≥18.0 kg/m²
  • * Hemoglobin:
  • * Diagnosed with Congestive Heart failure:
  • * Documented elevated NT-proBNP based on BMI and rhythm:
  • * NYHA Class II-IV
  • * Transferrin saturation (TSAT) \<20%
  • * Hemoglobin \<14 g/dL for men, \< 13 g/dL for women.
  • * Stable on heart failure therapy for ≥2-4 weeks
  • * Currently prescribed a diuretic at home
  • * Ambulatory (able to walk \>20 ft with minimal assistance)
  • * Willing and able to give informed consent
  • * Received IV iron, ESA, or blood transfusion within the last 6-12 months
  • * Received high-dose oral iron (\>100 mg/day in past 7 days)
  • * Severe renal impairment (eGFR \<15 mL/min/1.73 m² or on dialysis)
  • * Patients with known cirrhosis or transaminitis with AST \>141 or ALT \>112 IU/L
  • * Active bleeding or known bleeding disorder
  • * Recent cardiac surgery, myocardial infarction, or stroke within past 3 months
  • * Active infection, defined as any systemic or deep-seated infection (e.g., bacteremia, sepsis, osteomyelitis, or infections requiring IV antibiotics or hospitalization) at the time of screening.
  • * Active malignancy or undergoing chemotherapy/radiotherapy
  • * Vitamin B12 or folate deficiency (unless corrected prior to enrollment)
  • * Chronic liver disease (with LFTs \>3× upper limit of normal)
  • * Pregnant or breastfeeding women or those not using effective contraception
  • * Lacks capacity to consent or unable to comply with study procedures

Ages Eligible for Study

18 Years to 100 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Syed Hamza Mufarrih,

Study Record Dates

2027-03-31