Adjunctive Oral Iron Supplementation in Atopic Dermatitis
Adjunctive Oral Iron Supplementation in Atopic Dermatitis: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Eglal AM Bassiouny, PhD
- Phone Number: 00201061500242
- Email: eglal.mostafa@pharma.cu.edu.eg
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adolescents aged 12 to 16 years.
- Diagnosis of atopic dermatitis according to Hanifin and Rajka or UK Working Party criteria.
- Mild to moderate disease defined as EASI score 1.1-7.0 for mild and 7.1-21.0 for moderate disease, according to the severity classification of Leshem et al. (2015).
- Stable standard-of-care topical therapy for at least two weeks prior to enrolment.
- Willingness to maintain baseline topical therapy throughout the study period.
- Written informed consent from a parent or legal guardian and assent from the participant will be obtained prior to enrolment.
Exclusion Criteria:
Iron-related exclusions
- Known iron overload disorders (e.g., hereditary hemochromatosis).
- Ferritin above age- and sex-specific upper reference limits for adolescents (based on local laboratory pediatric reference ranges) in the absence of elevated CRP.
Use of oral or intravenous iron supplementation within the previous three months.
Hematologic exclusions
- Haemoglobin less than 8 g/dL. Participants excluded on this basis will be referred to the haematology clinic for evaluation and management of severe anaemia, in accordance with the Declaration of Helsinki (Article 37).
- Known hemoglobinopathies (e.g., thalassemia major, sickle cell disease).
- Active bleeding or known bleeding disorders. Dermatologic exclusions
- Presence of other chronic inflammatory skin diseases that may interfere with assessment (e.g., psoriasis, bullous disorders).
- Active skin infection requiring systemic antibiotic therapy.
Use of systemic treatments for atopic dermatitis, including:
- Systemic corticosteroids
- Immunosuppressants
- Biologic therapies within the following washout periods: dupilumab ≥12-16 weeks; cyclosporine ≥4 weeks; methotrexate ≥4-6 weeks; systemic corticosteroids ≥2-4 weeks.
Systemic exclusions
Severe chronic illnesses that may affect study participation or safety, including:
- Advanced kidney disease
- Chronic liver disease
- Any other medical condition that, in the investigator's judgment, may interfere with study participation or outcomes.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: standard-of-care topical therapy (emollients and steroids)
Participants will receive standard-of-care topical therapy (emollients and steroids).
Standard topical therapies for atopic dermatitis will be continued and documented.
|
|
|
Experimental: standard-of-care topical therapy (emollients and steroids)+ Oral Iron
Participants will receive (Ferrodunal capsules providing 100 mg elemental oral iron once daily) in addition to standard-of-care topical therapy (emollients and steroids).
The 100 mg fixed dose falls within the recommended paediatric dosing range of 3-6 mg/kg/day for most adolescents weighing ≥20 kg.
Iron supplementation will be discontinued if serum ferritin exceeds 300 ng/mL on two consecutive measurements.
|
Ferrodunal capsules providing 100 mg elemental oral iron once daily
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
• Change in Eczema Area and Severity Index (EASI) score from baseline to week 12.
Time Frame: 12 weeks
|
Higher scores indicate more severe atopic dermatitis, Minimum score is 0 and maximum is 72.
|
12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in SCORing Atopic Dermatitis (SCORAD) score from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate more severe disease and symptoms.
Maximum score is 103 and minimum is zero.
|
12 weeks
|
|
Change in Children's Dermatology Life Quality Index (CDLQI) from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate greater impairment in quality of life.
Score from 0 to 30.
|
12 weeks
|
|
Change in Patient-Oriented Eczema Measure (POEM) from baselines to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate worse eczema symptoms.
Maximum score is 28 and minimum is 0.
|
12 weeks
|
|
Change in EuroQol Visual Analogue Scale (EQ-VAS) from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate better perceived overall health.
Score is from 0 to 100.
|
12 weeks
|
|
Change in Peak Pruritus Numerical Rating Scale (PP-NRS) from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate more severe itching.
Score is from 0 to 10.
|
12 weeks
|
|
Change in serum ferritin from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Proportion of participants achieving EASI-50, EASI-75, and EASI-90.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Adverse events frequency
Time Frame: 12 weeks
|
12 weeks
|
|
|
Medication adherence will be assessed through capsule counts at each follow-up visit.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Correlation between baseline iron status strata and EASI score. (exploratory outcome)
Time Frame: 12 weeks
|
12 weeks
|
|
|
Correlation between change in iron biomarkers and change in EASI score. (exploratory outcome)
Time Frame: 12 weeks
|
12 weeks
|
|
|
Change in EQ-5D-Y index score from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
Higher scores indicate better health-related quality of life.
Usually ≤1 (can be negative in some tariffs).
|
12 weeks
|
|
Change in serum iron from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Change in serum hemoglobin from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Change in serum CRP from baseline to weeks 6 and 12.
Time Frame: 12 weeks
|
12 weeks
|
|
|
Medication adherence will be assessed through participant self-report at each follow-up visit.
Time Frame: 12 weeks
|
12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Eglal AM Bassiouny, PhD, Cairo University
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Genetic Diseases, Inborn
- Metabolic Diseases
- Immune System Diseases
- Hypersensitivity, Immediate
- Hypersensitivity
- Skin Diseases
- Skin Diseases, Genetic
- Skin Diseases, Eczematous
- Iron Metabolism Disorders
- Dermatitis
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Nutritional and Metabolic Diseases
- Skin and Connective Tissue Diseases
- Iron Deficiencies
- Dermatitis, Atopic
- Inorganic Chemicals
- Elements
- Metals
- Metals, Heavy
- Transition Elements
- Iron
Other Study ID Numbers
Other Study ID Numbers
- CL4181
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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