Comparison of Oral Ferrous Sulfate to Intravenous Ferumoxytol in Antepartum Iron Deficiency Anemia

Evaluate the extent to which treatment of iron deficiency anemia beyond 24-34 weeks' gestation of pregnancy with intravenous iron increases hemoglobin compared to oral iron. The investigators will test the hypothesis that pregnant women who are anemic in the second and third trimester are more likely to significantly increase their hemoglobin with intravenous iron as opposed to the usual standard of care, oral iron.

Study Overview

• Status: Completed
• Conditions: Pregnancy Related; Anemia, Iron Deficiency
• Intervention / Treatment: Drug: Ferumoxytol Injection [Feraheme]; Drug: Ferrous Sulfate

• Study Type: Interventional
• Enrollment (Actual): 83
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • California
    • Stanford, California, United States, 94305
      • Stanford University School of Medicine/Lucile Packard Childrens Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Pregnant women 18 years old and above
2. Hemoglobin < 11 g/dL, serum ferritin < 30 ug/dL and or transferrin saturation (TSAT) < 20%
3. Between 24-34 weeks' pregnancy
4. Singleton pregnancy
5. Receiving prenatal care at Stanford/LPCH OB clinic and planning to deliver at LPCH
6. Hemodynamically stable

Exclusion Criteria:

1. Patients unable to give informed consent
2. Known allergy/hypersensitivity to IV iron
3. Inflammatory Bowel Disease or history of gastric bypass surgery
4. Dialysis-dependent Chronic Kidney Disease/ ESRD
5. Known Hemoglobinopathies such as sickle cell disease, beta-thalassemia, alpha thalassemia
6. Folate/Vitamin B12 deficiency
7. Known malignancy
8. Medication allergy to Tylenol (acetaminophen)
9. Hemoglobin above 12 or less than 7 g/dL
10. Patients with complex past medical histories which may include history of multiple medication allergies (greater than 2 allergies), connective tissue disorder, etc.
11. Diagnosis of placenta previa

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intravenous iron; Participants will receive 510mg intravenous iron ferumoxytol, with a maximum of 2 doses based on the baseline hemoglobin level. The ferumoxytol is administered as an infusion for approximately 15 - 30 minutes.	Drug: Ferumoxytol Injection [Feraheme]; 510mg intravenous ferumoxytol
Active Comparator: Oral iron; Participants will be prescribed 1-2 ferrous sulfate 325mg tablets by mouth (based on severity of anemia) until delivery. For standardization, the dosage is as follows based on severity: one ferrous sulfate tablet for women with baseline hemoglobin 9-11, and two ferrous sulfate tablets for hemoglobin < 9.	Drug: Ferrous Sulfate; 325mg oral ferrous sulfate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Change in Hemoglobin Value Before and After Intervention	Hemoglobin is measured as g/dL at enrollment and after the study intervention	From enrollment to four weeks post-enrollment (may have been up to 6 weeks post-enrollment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants Who Discontinued Treatment		From enrollment to delivery or birth admission (average approximately 8 to 12 weeks)
Number of Participants With Serious Adverse Events Associated With Treatment		From enrollment to delivery or birth admission (average approximately 8 to 12 weeks)
Number of Participants Who Need Blood Transfusion Postpartum		From enrollment to delivery or birth admission (average approximately 8 to 12 weeks)
Change in Short Form (SF-)36 General Health Symptom Score	Score range: 0 to 100 (lower scores indicate more severe symptoms, higher scores correspond to fewer symptoms)	From enrollment to four weeks post-enrollment (may have been up to 6 weeks post-enrollment)
Change in Short Form (SF-)36 Physical Functioning Score	Score range: 0 to 100 (lower scores indicate less physical function, higher scores correspond to more physical function).	From enrollment to four weeks post-enrollment (may have been up to 6 weeks post-enrollment)
Change in Short Form (SF-)36 Role Limitations Due to Physical Health Score	Score range: 0 to 100 (lower scores indicate more limitations, higher scores correspond to fewer limitations).	From enrollment to four weeks post-enrollment (may have been up to 6 weeks post-enrollment)
Change in Short Form (SF-)36 Energy/Fatigue Score	Score range: 0 to 100 (lower scores indicate more fatigue, higher scores correspond to more energy).	From enrollment to four weeks post-enrollment (may have been up to 6 weeks post-enrollment)

Collaborators and Investigators

• Sponsor: Stanford University
• Collaborators: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• Investigators: Principal Investigator: Deirdre Lyell, Stanford University; Principal Investigator: Irogue Igbinosa, MD, Stanford University

Study record dates

Study Major Dates

• Study Start (Actual): January 21, 2021
• Primary Completion (Actual): July 1, 2024
• Study Completion (Actual): July 1, 2024

Study Registration Dates

• First Submitted: January 31, 2020
• First Submitted That Met QC Criteria: February 3, 2020
• First Posted (Actual): February 5, 2020

Study Record Updates

• Last Update Posted (Estimated): August 26, 2025
• Last Update Submitted That Met QC Criteria: August 22, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Metabolic Diseases; Hematologic Diseases; Anemia; Iron Metabolism Disorders; Anemia, Hypochromic; Nutritional and Metabolic Diseases; Hemic and Lymphatic Diseases; Iron Deficiencies; Anemia, Iron-Deficiency; Inorganic Chemicals; Ferric Compounds; Iron Compounds; Ferrous Compounds; Minerals; Ferrosoferric Oxide; ferrous sulfate
• Other Study ID Numbers: 54788; K12HD103084 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No