A prospective randomized wait list control trial of intravenous iron sucrose in older adults with unexplained anemia and serum ferritin 20-200 ng/mL

Blood Cells Mol Dis. 2014 Dec;53(4):221-30. doi: 10.1016/j.bcmd.2014.06.003. Epub 2014 Jul 25.

Abstract

Anemia is common in older persons and is associated with substantial morbidity and mortality. One third of anemic older adults have unexplained anemia of the elderly (UAE). We carried out a randomized, wait list control trial in outpatients with UAE and serum ferritin levels between 20 and 200 ng/mL. Intravenous iron sucrose was given as a 200-mg weekly dose for 5 weeks either immediately after enrollment (immediate intervention group) or following a 12-week wait list period (wait list control group). The primary outcome measure was changed in 6-minute walk test (6MWT) distances from baseline to 12 weeks between the two groups. Hematologic, physical, cognitive, and quality of life parameters were also assessed. The study was terminated early after 19 subjects enrolled. The distance walked in the 6MWT increased a mean 8.05±55.48 m in the immediate intervention group and decreased a mean 11.45±49.46 m in the wait list control group (p=0.443). The hemoglobin increased a mean 0.39±0.46 g/dL in the immediate intervention group and declined a mean 0.39±0.85 g/dL in the wait list control group (p=0.026). Thus, a subgroup of adults with UAE may respond to intravenous iron. Enrollment of subjects into this type of study remains challenging.

Keywords: 6-Minute walk test; Hemoglobin; Intravenous iron; Unexplained anemia.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / blood
  • Anemia / drug therapy*
  • Anemia / pathology
  • Cognition / drug effects
  • Drug Administration Schedule
  • Exercise Test
  • Female
  • Ferric Compounds / therapeutic use*
  • Ferric Oxide, Saccharated
  • Ferritins / blood*
  • Glucaric Acid / therapeutic use*
  • Humans
  • Injections, Intravenous
  • Male
  • Psychological Tests
  • Quality of Life
  • Walking / physiology

Substances

  • Ferric Compounds
  • Ferritins
  • Ferric Oxide, Saccharated
  • Glucaric Acid