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Phase 2 N=100 Randomized Treatment

Practical Anemia Bundle for SusTained Blood Recovery

Anemia · Critical Illness

Enrolled (actual)
100
Serious AEs
4.0%
Results posted
Apr 2025
Primary outcome: Primary: Hemoglobin Concentrations — 11.5; 12.2 g/dL — p=0.02

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Iron Dextran (Drug); Erythropoietin (EPO) (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Mayo Clinic
Primary completion
Mar 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Hemoglobin Concentrations
9.0; 9.6; 12.8; 13.4 0.04 sig
SECONDARY
Hemoglobin Concentrations
9.0; 9.6; 12.8; 13.4 0.04 sig
SECONDARY
Phlebotomy Practice-Blood Draws
46; 32 0.352
SECONDARY
Phlebotomy Practice-Volume
142; 32 <0.001 sig
SECONDARY
Patient-Reported Quality of Life Measured by EuroQol (EQ-5D)
60; 51; 65; 70; 80; 80 0.94
SECONDARY
Anemia-related Fatigue Measured by Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale
28; 32; 37; 41; 44; 46 0.23
SECONDARY
6 Minute Walk Distance
1080; 1211; 1208; 1220 0.13
SECONDARY
Cognitive Function After Critical Illness Assessed Using Montreal Cognitive Assessment (MoCA-BLIND)
19; 20; 20; 21 0.12
SECONDARY
Mental Health - Anxiety and Depression Measured Using the Hosptial Anxiety and Depression Scale (HADS)
2; 1; 1; 0; 4; 2 0.29
SECONDARY
Mental Health - Post-Traumatic Distress Using Impact of Events Scale-Revised (IES-R)
1; 3; 0; 0 0.56
SECONDARY
Number of Participants With Allogeneic Red Blood Cell Transfusions
6; 1 0.09
SECONDARY
Number of Transfused Units of Allogeneic Red Blood Cells
0; 0
SECONDARY
Unplanned Hospital Readmissions
16; 12; 30; 24 0.48
SECONDARY
Mortality
1; 2; 2; 3 0.54
SECONDARY
Adverse Events Post-enrollment
4; 2; 2; 0; 2; 1
SECONDARY
Accelerometry-measured Number of Steps Taken Per Day
6481; 6017; 8281; 6874
SECONDARY
Accelerometry-measured Daily Maximum Step Cadence
67.0; 64.4; 71.1; 61.4

Summary

The purpose of this study is to test a multi-faceted anemia treatment plan to reduce the severity of anemia and to promote hemoglobin and functional recovery in adults who have been in the intensive care unit (ICU).

Eligibility Criteria

Inclusion Criteria

  • Provision of signed and dated informed consent form (may be completed by legal proxies for those patients unable to provide consent, i.e. sedation/intubation)
  • Stated willingness to comply with all study procedures and availability for the duration of the study, including follow-up assessments
  • Current ICU admission at Mayo Clinic Rochester with anticipated ICU duration >48 hours after enrollment
  • Current ICU duration < 7 days
  • Patients embedded in the local or regional Mayo Clinic Health System to facilitate post-hospitalization outcome assessment
  • Moderate-to-severe anemia (i.e. hemoglobin concentration < 10 g/dL) at the time of enrollment, with the hemoglobin concentration assessed no more than 24 hours prior to enrollment. If RBC transfusion has been administered between the qualifying hemoglobin assessment and enrollment, a repeat hemoglobin will be required prior to enrollment to ensure that it remains < 10 g/dL.

Exclusion Criteria

  • Recent or current IV iron or erythropoiesis stimulating agent (ESA) use (i.e. darbepoetin, Aranesp, erythropoietin, Epogen, Procrit, Retacrit) within 30 days of enrollment
  • Severe anemia prior to hospitalization (i.e. hemoglobin <9 g/dL within 90 days of admission)
  • Known allergic reactions to iron or EPO
  • Inability to complete outcome assessments (i.e. not expected to survive hospitalization, unable to make follow-up appointments, non-ambulatory, dementia or other severe cognitive impairment, visual impairment i.e. blind or legally blind)
  • Pregnancy or breastfeeding at time of enrollment
  • Inability to receive pharmacologic venous thromboembolic prophylaxis except in patients with recent surgical or gastrointestinal bleeding
  • Active or suspected thrombosis (i.e. deep venous thrombosis, pulmonary embolism, acute arterial thrombus within 3 months)
  • Uncontrolled sepsis (i.e. <48 hours of appropriate antimicrobial therapy and/or lack of definitive source control)
  • Having received ≥10 units of allogeneic RBCs in the 48 hours before enrollment
  • Acute coronary syndrome or ischemic stroke within 3 months
  • Weight less than 40 kg
  • Concerns with study enrollment expressed by the clinical team
  • Mechanical circulatory support devices
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT05167734). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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