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Is untargeted iron supplementation harmful when iron deficiency is not the major cause of anaemia? Study protocol for a double-blind, randomised controlled trial among non-pregnant Cambodian women.

BMJ open
January 1, 1970
Jordie Aj Fischer et al. (7 authors)
Clinical Trial ProtocolJournal ArticleResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine if untargeted iron supplementation poses potential harm and to compare the effects of two forms of iron (ferrous sulfate and ferrous bisglycinate) versus placebo.

Results Summary

The abstract does not provide results; it describes the study design and planned measurements, including ferritin concentrations and markers of potential harm in blood and stool.

Population

Non-pregnant women aged 18-45 years in Cambodia.

Effective Dosage

60 mg elemental iron as ferrous sulfate or 18 mg ferrous bisglycinate, administered daily.

Duration

12 weeks

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
daily oral iron supplementation for 12 weeks
neutral
anaemia prevalence
women and adolescents where anaemia prevalence is greater than 40%
-
recommends
#1
untargeted iron supplementation
neutral
-
where iron deficiency is not a major cause of anaemia
-
is a waste of resources; at worst, it could cause harm
#2
different forms of iron with varying bioavailability
neutral
-
-
-
may present greater risks of harm
#3
untargeted iron supplementation
neutral
-
non-pregnant women (ages 18-45 years)
-
determine if there is potential harm associated with
#4
60 mg elemental iron as ferrous sulfate
neutral
-
non-pregnant women (ages 18-45 years)
-
receive
#5
18 mg ferrous bisglycinate
neutral
-
non-pregnant women (ages 18-45 years)
-
receive
#6
placebo
neutral
-
non-pregnant women (ages 18-45 years)
-
receive
#7
iron
neutral
ferritin concentration
-
-
assess the effect of
#8
iron
neutral
markers of potential harm
-
-
assess the effect of
#9
Abstract

INTRODUCTION: The WHO recommends daily oral iron supplementation for 12 weeks in women and adolescents where anaemia prevalence is greater than 40%. However, if iron deficiency is not a major cause of anaemia, then, at best, untargeted iron supplementation is a waste of resources; at worst, it could cause harm. Further, different forms of iron with varying bioavailability may present greater risks of harm. METHODS AND ANALYSIS: A 12-week three-arm, double-blind, randomised controlled supplementation trial was conducted in Cambodia to determine if there is potential harm associated with untargeted iron supplementation. We will recruit and randomise 480 non-pregnant women (ages 18-45 years) to receive one of three interventions: 60 mg elemental iron as ferrous sulfate (the standard, commonly used form), 18 mg ferrous bisglycinate (a highly bioavailable iron amino acid chelate) or placebo. We will measure ferritin concentrations (to evaluate non-inferiority between the two forms of iron), as well as markers of potential harm in blood and stool (faecal calprotectin, gut pathogen abundance and DNA damage) at baseline and 12 weeks. Mixed-effects generalised linear models will be used to assess the effect of iron on ferritin concentration and markers of potential harm at 12 weeks. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of British Columbia Clinical Research Ethics Board (H18-02610), the Children's and Women's Health Centre of British Columbia Research Ethics Board (H18-02610) and the National Ethics Committee for Health Research in Cambodia (273-NECHR). Findings will be published in peer-reviewed journals, presented to stakeholders and policymakers globally and shared within participants' communities. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04017598).

Medical Subject Headings (MeSH)
AdolescentAdultAnemiaAnemia, Iron-DeficiencyAsian PeopleBritish ColumbiaCambodiaDietary SupplementsDouble-Blind MethodFemaleHumansIronMiddle AgedRandomized Controlled Trials as TopicYoung Adult
Study Links
Quality Scores
SafetyNot Assessed
Quality85/10
Citation Metrics
Total Citations5
Citations/Year1.0
Relative Citation Ratio0.37
NIH Percentile20.1%
Research Impact Scores
APT Score0.25
Weight Score1.63
Normalized Score0.57
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