The Impact of IV Iron on Exercise Capacity and Quality of Life in Pulmonary Hypertension

NCT07359599 | Recruiting Phase 4

• 2 other identifiers: Z-20250902025-522936-14-00
• Study Type: interventional
• Target: 306
• Locations: 1 country
• Sites: 7

Brief Summary

Pulmonary hypertension (PH) is a condition characterized by elevated blood pressure in the pulmonary arteries. This leads to symptoms such as shortness of breath and a significantly reduced exercise capacity, resulting in a very poor quality of life. Currently, treatment options for PH are limited. More than 60% of patients with PH develop iron deficiency. Studies have shown that this deficiency is associated with more severe symptoms, reduced exercise capacity, and even lower quality of life. Oral iron supplements are often ineffective in these patients due to impaired absorption in the intestines, caused by chronic low-grade inflammation-a common feature in PH. Intravenous iron administration can rapidly correct the deficiency, but it remains unclear whether this also leads to clinical improvements such as enhanced exercise capacity, reduced shortness of breath, and improved quality of life. Moreover, the cost-effectiveness of this treatment is still unknown. The IRON-PH study aims to answer these questions. As part of the IRON-PH study, 306 patients with pulmonary hypertension will be enrolled. Each patient will be randomized to receive either intravenous iron (ferric carboxymaltose) or intravenous placebo (NaCl 0.9%).

Conditions

Iron Deficiency; Pulmonary Hypertension

Outcome Measures

Primary Outcomes (1)

• Change in 6MWD

  Change in 6-minute walking distance (6MWD) from baseline to 24 week follow-up

  From baseline to 24 week follow-up

Secondary Outcomes (4)

• Change in MLHFQ

  Baseline to 24 week follow-up

• Change in EQ5D5L

  Baseline to 24 week follow-up

• Change in FSS

  Baseline to 24 week follow-up

• Developing composite clinical worsening event

  From first patient Day 1 (Baseline) to study completion, an average of 2 years

Study Arms (2)

Ferric carboxymaltose

EXPERIMENTAL

Drug: Ferric Carboxymaltose (FCM)

Placebo

PLACEBO COMPARATOR

Drug: Sodium Chloride (NaCl) 0.9 %

Interventions

Ferric Carboxymaltose (FCM) DRUG

Ferric Carboxymaltose (FCM), dosing and administration according to SmPC guidelines

Ferric carboxymaltose

Sodium Chloride (NaCl) 0.9 % DRUG

Placebo, dosing and administration according to SmPC guidelines

Placebo

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ≥18 years of age
• WHO functional class II - IV
• Iron deficiency defined as TSAT \<21% (no more than ≥3 months old at randomization)
• PH defined by echocardiography and/or right heart catheterization (RHC) according to the following WHO groups:
• Group 1 PH:
• Patients with a diagnosis of idiopathic PAH, hereditary PAH, drug induced PAH or PAH and associated with CTD or CHD (historical RHC available) on stable and optimized doses of PAH targeted therapies for at least 4 weeks before randomization.
• Echocardiographic evidence of a high or intermediate probability for PH as per 2022 ESC PH guidelines.
• Group 2 PH and baseline LVEF \> 50% on imaging modality within last 6 months before randomization and on stable doses of loop diuretics and HFpEF therapies for 4 weeks. Group 2 PH can be included based on echocardiography or RHC.:
• Echocardiography (\<6mo before randomization):
• Presence of LVH or LA-enlargement
• E/e' \>15 (at rest or exercise)
• TRVmax \>2.8 m/s (at rest) or mPAP/CO\>3 mHg/L/min (exercise) or echocardiographic evidence of high or intermediate probability for PH as per 2022 ESC PH guidelines.
• RHC (\<6mo before randomization)
• mPAP \> 20 mmHg
• PCWP \> 15 mmHg at rest or PCWP/CO-slope \> 2mmHg/L/min or exercise PCWP\>25mmHg, or PCWP 13-15 mmHg with elevation ≥18mmHg after 500 cc Fluid Challenge

You may not qualify if:

• Screening haemoglobin \< 8 g/dl or \>15 g/dl
• Ferritin \> 700 ng/mL
• Known hypersensitivity reaction to any component of FCM
• Group 1 PH associated with veno-occlusive diseases.
• Primary diagnosis of group 3 PH
• Primary diagnosis of group 5 PH
• Treatment with oral or other IV iron therapies at screening.
• Current or planned mechanical circulatory support or lung/heart transplantation.
• Any planned surgery or procedure leading to expected significant blood loss (defined as more than 250 ml = equal to 125mg of iron).
• Haemodialysis or peritoneal dialysis (current or planned within the next 24 weeks).
• Inability to return for follow up visits within the necessary windows
• Concurrently in a study with another investigational product.
• Uncorrected moderate to severe aortic stenosis (AVA \<1.5cm² and mean gradient \>20 mmHg) or severe valvular regurgitation (except tricuspid regurgitation)
• Impression by investigator that patient cannot perform a 6MWT
• Active infection as judged by the investigator.

Sponsors & Collaborators

• Ziekenhuis Oost-Limburg: lead
• Federal Knowledge Centre (KCE): collaborator

Study Sites (7)

AZORG

Aalst, 9300, Belgium

NOT YET RECRUITING

Hôpital Erasme

Brussels, 1070, Belgium

NOT YET RECRUITING

Ziekenhuis Oost-Limburg

Genk, 3600, Belgium

RECRUITING

AZ Groeninge

Kortrijk, 8500, Belgium

NOT YET RECRUITING

UZ Leuven

Leuven, 3000, Belgium

NOT YET RECRUITING

CHU Charleroi-Chimay

Lodelinsart, 6042, Belgium

NOT YET RECRUITING

CHU UCL Namur

Yvoir, 5530, Belgium

NOT YET RECRUITING

MeSH Terms

Conditions

Hypertension, Pulmonary; Iron Deficiencies

Interventions

ferric carboxymaltose; Sodium Chloride

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases; Hypertension; Vascular Diseases; Cardiovascular Diseases; Iron Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Chlorides; Hydrochloric Acid; Chlorine Compounds; Inorganic Chemicals; Sodium Compounds

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 9, 2026
• First Posted: January 22, 2026
• Study Start: January 27, 2026
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): October 1, 2028
• Last Updated: January 30, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

BE (7)