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Die Auswirkungen von Eisenderisomaltose bei Patienten mit akuter Herzinsuffizienz und Eisenmangel auf die körperliche Leistungsfähigkeit und Lebensqualität (COREVIVE-HFrEF) (COREVIVE-HFrEF)

4. November 2026 aktualisiert von: Jingyi Ren, China-Japan Friendship Hospital

Die Auswirkungen der vor der Entlassung aus dem Krankenhaus verabreichten Eisenderisomaltose bei stabilisierten Patienten mit akuter Herzinsuffizienz und Eisenmangel auf die körperliche Leistungsfähigkeit und Lebensqualität: eine randomisierte, doppelblinde, placebokontrollierte Parallelgruppenstudie (COREVIVE-HFrEF)

This study will address whether the additional use of Ferric Derisomaltose on top of standard care will improve exercise capacity and quality of life in patients with acute heart failure and iron deficiency. One group of participants will receive treatment with Ferric Derisomaltose and the other group will receive normal saline 0.9% as placebo.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Acute heart failure (AHF) is a very common medical problem. Despite improvements in treatment, many patients suffer limiting exercise capacity and quality of life. Previous comorbidities may account for it. Approximately 80% of patients hospitalized with AHF suffered from a combination of iron deficiency. A decline in exercise capacity may occur under this condition. Some research studies have suggested that giving CHF patients intravenous iron improves symptoms in the short term. It is unknown, however, whether correcting iron deficiency is beneficial to patients with AHF to improve excise capacity and whether it improves quality of life and accelerate recovery from acute duration. This study will help us answer these key questions.

This is an investigator-initiated, randomised, parallel group, double-blind, placebo-controlled trial, evaluating the excise capacity improvement of using ferric derisomaltose versus placebo in hospitalized patients with acute heart failure with reduced ejection fraction before discharge.

Participants will be assessed daily using 6-minute walking test after IV iron injection until discharge from hospital, especially focus on the change from baseline to the 3rd day. Some questionnaires are also conducted to evaluate the self-reported status. Participants will be followed up at 2 weeks and 4 weeks.

The primary and secondary endpoints will be examined in subgroups predefined by baseline variables reflecting demography, Hb level, etiology of HF, left ventricular ejection fraction, natriuretic peptide, index of iron metabolism, eGFR and others.

Studientyp

Interventionell

Einschreibung (Geschätzt)

146

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • Beijing Municipality
      • Beijing, Beijing Municipality, China
        • Rekrutierung
        • China-Japan Friendship Hospital
        • Kontakt:

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  1. Age ≥18 years.

  2. Clinical diagnosis of heart failure with reduced ejection fraction (HFrEF), defined as documented 2-dimensional echocardiography left ventricular ejection fraction (LVEF) <50% before randomization.

  3. Currently hospitalised for an episode of acute heart failure (AHF) where AHF was the primary reason for hospitalisation, New York Heart Association (NYHA) class II - IV.

  4. Reaching hemodynamic stability after standard treatment (if tolerated, initiate four pillars of guideline-directed medical therapies). All of the following (i.e., items a to c) must apply:

    1. Systolic blood pressure≥100mmHg, without symptoms of hypotension;
    2. Stop using intravenous diuretics;
    3. Neither intravenous inotropic drugs or vasodilators were used (including nitrates).
  5. Subject is iron deficient defined as serum ferritin <100 ng/mL or 100 ng/mL ≤ serum ferritin ≤299 ng/mL if TSAT <20%.

  6. Able and willing to provide informed consent and accomplish 6 minutes-walking test.

Exclusion Criteria:

  1. Hematological criteria: ferritin >400 ug/L; hemoglobin <9.0, hemoglobin >13.5 g/dL in women or >14.5 g/dL in men.
  2. Renal dialysis or MDRD/CKD-EPI estimated glomerular filtration rate (eGFR) <15ml/min/1.73m2
  3. Body weight <35kg at randomization.
  4. Heart failure was secondary to valvular diseases or congenital heart diseases.
  5. History of acquired iron overload or hemochromatosis (or first-degree relative of hemochromatosis)
  6. Known hypersensitivity reaction to any component of ferric derisomaltose (Monofer®) or any of its excipients (water for injections, sodium hydroxide (for pH adjustment), hydrochloric acid (for pH adjustment)).
  7. Non-iron deficiency anaemia.
  8. Already receiving erythropoiesis stimulating agents (ESA) or other iron supplements in previous 4 weeks prior to randomization.
  9. Active infection (defined as currently treated with oral or intravenous antibiotics), bleeding (gastrointestinal haemorrhagia, menorrhagia, history of peptic ulcer with no evidence of healing or inflammatory bowel disease) and history of malignant tumor.
  10. Any of the following diseases that hinders exercise testing: severe musculoskeletal disease, unstable angina, obstructive cardiomyopathy, severe uncorrected valvular disease, or uncontrolled slow or rapid arrhythmia (mean ventricular rate> 100 beats / min at rest).
  11. Known positive HBsAg and/or HCV RNA; known HIV positivity; chronic liver disease (including active hepatitis), hepatic sclerosis, ALT or AST > 3x upper limit of normal.
  12. Within 3 months of any of the following: acute myocardial infarction (AMI) or acute coronary syndrome (ACS), transient ischemic attack (TIA) or stroke, uncontrolled hypertension.
  13. Revascularization therapy (coronary artery bypass grafting, percutaneous intervention, or major surgery) in the past 3 months; or planning cardiac surgery or revascularization.
  14. Baseline 6 minutes-walking distance>500m.
  15. Treated with long-term oral high-dose or steroid-immunosuppression therapy.
  16. Investigator considers a possible alternative diagnosis to explain the patient's HF symptoms: severe obesity, primary pulmonary hypertension, or chronic obstructive pulmonary disease (COPD).
  17. Subject is pregnant (e.g., positive human chorionic gonadotropin test) or breast feeding.
  18. Untreated hypothyroidism.
  19. Currently enrolled in any other investigational device or drug study <30 days prior to screening, or received other investigational agent(s).

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Doppelt

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Ferric derisomaltose

Iron to be administered as ferric derisomaltose.

The treatment dose (mL) to be administered will be determined by the patient's body weight and hemoglobin (Hb) value.

Where Hb ≥10 g/dL, dosage according to body weight is as follows:

Body weight <50 kg: 20 mg/kg; Body weight 50 to <70 kg: 1000 mg; Body weight ≥70 kg: 20 mg/kg up to a maximum of 1500 mg.

Where Hb <10 g/dL, dosage according to body weight is as follows:

Body weight <50 kg: 20 mg/kg; Body weight 50 to <70 kg: 20 mg/kg; Body weight ≥70 kg: 20 mg/kg up to a maximum of 2000 mg.

Infused over a minimum of 15mins for doses up to and including 1000mg, and a minimum of 30 mins for doses >1000mg

After baseline assessments patients will be randomised in a 1:1 ratio to receive ferric derisomaltose IV or placebo (normal saline). In the Treatment group, Ferric derisomaltose will be administered according to the dosing schedule.

Andere Namen:
  • Monofer
  • Eisen(III)isomaltosid 1000
Placebo-Komparator: Placebo

Participants in this arm will receive normal saline 0.9% in analogy to treatment arm.

In the placebo group, patients will receive the equivalent number of normal saline injections.

Andere Namen:
  • Normale Kochsalzlösung

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in 6-minute walking distance
Zeitfenster: Up to 3 days

The difference of 6-minute walking distance in meters from baseline to day3 after IV iron injection.

Up to 3 days

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change From Baseline in 6-minute walking distance
Zeitfenster: At 2 weeks, 4weeks after IV iron injection

The difference of 6-minute walking distance in meters from baseline at 2 weeks, 4weeks after IV iron injection.

At 2 weeks, 4weeks after IV iron injection
Change From Baseline in the KCCQ Clinical Summary Score
Zeitfenster: At 2 weeks, 4weeks after IV iron injection

KCCQ was a 23-item, self-administered questionnaire that measure the participant's perception of their health status, including their heart failure (HF) symptoms, impact on physical and social function and how their HF impacts the quality of life. KCCQ quantifies 7 domains: physical limitations (6 items), symptom stability (1 item), symptom frequency (4 items), symptom burden (3 items), self-efficacy (2 items), quality of life (3 items) and social limitations (4 items). Scores were generated for each domain and scaled from 0 to 100, with 0 denoting the worst and 100 the best possible status. KCCQ-clinical summary score was average of domains- physical limitation and total symptoms (average of symptom frequency and symptom burden), and transformed to a single score which ranged from 0 (worst) -100 (the best possible status), where the higher score reflected better health status.

At 2 weeks, 4weeks after IV iron injection
Change From Baseline in the EQ-5D-5L Questionnaire Indexed Value
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

EQ-5D-5L: European Quality of Life-5 Dimensions-5 Levels The EQ 5D questionnaire consists of a health descriptive system for participants to self-classify and rate their health status on the day of administration.

The descriptive system includes 5 items/dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression, which are coded from 1 (best state) to 5 (worst state).

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in NYHA Functional Class
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

NYHA = New York Heart Association

NYHA functional class was assessed as Class I, II, III, IV:

Class I - No symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc.

Class II - Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.

Class III - Marked limitation in activity due to symptoms, even during less-than-ordinary activity. Comfortable only at rest.

Class IV - Severe limitations. Experiences symptoms even while at rest.

Lower response categories are better for score NYHA.

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in PGA quality of life questionnaire
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

PGA:Patient Global Assessment

PGA questionnaire consists of a health descriptive system for participants to self-reported and rate their medical condition after participate this study.

The descriptive system includes 7 choices:has much improved, has (moderately) improved, has a little improved, is unchanged, is a little worse, is (moderately) worse, is much worse, which are coded from 1 (best state) to 7 (worst state).

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in Concentration of hemoglobin (Hb)
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

Hemoglobin (Hb) is a commonly used clinical test for assessing anaemia, with units of g/L.

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in proportion of reticulocyte (Ret%)
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

The reticulocyte ratio is often used to reflect the hematopoiesis of the bone marrow erythrocyte with units of percentage(%).

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in Concentration of ferritin
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

To assess the effect of ferric derisomaltose vs. placebo on change in ferritin from baseline to 3 days, 2weeks and 4weeks

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in concentration of transferrin saturation
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

To assess the effect of ferric derisomaltose vs. placebo on change in transferrin saturation from baseline to 3 days, 2weeks and 4weeks

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in Concentration of serum transferrin receptors (sTfR)
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

To assess the effect of ferric derisomaltose vs. placebo on change in serum transferrin receptors (sTfR) from baseline to 3 days, 2weeks and 4weeks

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in Concentration of N-terminal Pro-brain Natriuretic Peptide (NT-proBNP)
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

To assess the effect of ferric derisomaltose vs. placebo on change in NT-proBNP from baseline to 3 days, 2weeks and 4weeks

At 3 days, 2weeks, 4weeks after IV iron injection
Change From Baseline in Left Ventricular Systolic Function
Zeitfenster: At 2weeks, 4weeks after IV iron injection

Left ventricular ejection fraction is assessed by two-dimensional directed M-mode echocardiography.

At 2weeks, 4weeks after IV iron injection
Change From Baseline in Left Ventricular End-Diastolic Diameter
Zeitfenster: At 2weeks, 4weeks after IV iron injection

Left ventricular end-diastolic diameter is assessed by two-dimensional directed M-mode echocardiography.

At 2weeks, 4weeks after IV iron injection

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change From Baseline in Urine Albumin-to-Creatinine Ratio (UACR)
Zeitfenster: At 3 days, 2weeks, 4weeks after IV iron injection

Urine Albumin-to-Creatinine Ratio (UACR) is regard as a safety endpoint to reflect early injury of kidney.

At 3 days, 2weeks, 4weeks after IV iron injection
A rise of high-sensitivity C-reaction protein (hs-CRP) levels from baseline
Zeitfenster: Up to 4weeks

Safety endpoint is defined as a rise of high-sensitivity C-reaction protein (hs-CRP) from baseline.

Up to 4weeks
Adverse Event after IV iron injection
Zeitfenster: Up to 4weeks

Adverse Event Include Fishbane symptoms (flushing/chest pain/back pain/chest tightness, sometimes with dyspnea), isolated signs and symptoms (urticaria/pruritus/rash/mild hypotension, hypertension/tachycardia/nausea/headache), signs and symptoms of allergic reactions (persistent hypotension; airway angioedema/generalised urticaria, non-airway angioedema/wheezing, bronchospasm, vomiting, abdominal pain, etc.)

Up to 4weeks

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. August 2023

Primärer Abschluss (Geschätzt)

1. August 2027

Studienabschluss (Geschätzt)

1. August 2027

Studienanmeldedaten

Zuerst eingereicht

13. Juli 2023

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

25. Juli 2023

Zuerst gepostet (Tatsächlich)

2. August 2023

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

6. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

4. November 2026

Zuletzt verifiziert

1. November 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • Monofer-HFrEF

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Nein

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