title: A prospective randomized wait list control trial of intravenous iron sucrose in older adults with unexplained anemia and serum ferritin 20-200 ng/mL.
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.
authors: Division of Pulmonary and Critical Care Medicine, 300 Pasteur Drive, Room H3143, MC 5236 Stanford, CA 94305, USA. Electronic address: eaprice@stanford.edu.
authors: Elizabeth
authors: E
authors: Price
authors: University of Chicago, 5841 S Maryland Ave., Chicago, IL 60637, USA. Electronic address: aartz@medicine.bsd.uchicago.edu.
authors: Andrew S
authors: AS
authors: Artz
authors: Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. Electronic address: huiman.barnhart@duke.edu.
authors: Huiman
authors: H
authors: Barnhart
authors: Duke University Medical Center, Durham, NC 27710, USA. Electronic address: shelly.sapp@duke.edu.
authors: Shelly
authors: S
authors: Sapp
authors: Center for Alzheimer's Care, Imaging and Research, University of Utah, Dept. of Neurology, 650 Komas Drive, Salt Lake City, UT 84108, USA. Electronic address: gordon.chelune@hsc.utah.edu.
authors: Gordon
authors: G
authors: Chelune
authors: Institute for Advanced Studies in Aging, 6400 Arlington Blvd., Falls Church, VA 22042, USA. Electronic address: wershler@iasia.org.
authors: William B
authors: WB
authors: Ershler
authors: Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: jwalston@jhmi.edu.
authors: Jeremy D
authors: JD
authors: Walston
authors: University of Illinois at Chicago, Clinical Science North Bldg., 820S Wood St., Chicago, IL 60612, USA. Electronic address: vgordeuk@uic.edu.
authors: Victor R
authors: VR
authors: Gordeuk
authors: Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA. Electronic address: nab@case.edu.
authors: Nathan A
authors: NA
authors: Berger
authors: University of California, Los Angeles Medical Center, 10945 Le Conte Ave., Los Angeles, CA 90095, USA. Electronic address: dreuben@mednet.ucla.edu.
authors: David
authors: D
authors: Reuben
authors: University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: josef.prchal@hsc.utah.edu.
authors: Josef
authors: J
authors: Prchal
authors: Duke University Medical Center, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA. Electronic address: sunil.rao@dm.duke.edu.
authors: Sunil V
authors: SV
authors: Rao
authors: Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: croy6@jhmi.edu.
authors: Cindy N
authors: CN
authors: Roy
authors: University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132, USA. Electronic address: mark.supiano@utah.edu.
authors: Mark A
authors: MA
authors: Supiano
authors: Stanford University, Stanford, CA 94305, USA. Electronic address: sschrier@stanford.edu.
authors: Stanley L
authors: SL
authors: Schrier
authors: Duke University Medical Center, Center for the Study of Aging, Box 3003, Durham, NC 27710, USA. Electronic address: harvey.cohen@dm.duke.edu.
authors: Harvey Jay
authors: HJ
authors: Cohen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D003071:Cognition / Q000187:drug effects; D004334:Drug Administration Schedule; D005080:Exercise Test; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use*; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood*; D005937:Glucaric Acid / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011581:Psychological Tests; D011788:Quality of Life; D016138:Walking / Q000502:physiology
chemical_list: D005290:Ferric Compounds; D005293:Ferritins; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid
keywords: 6-Minute walk test; Hemoglobin; Intravenous iron; Unexplained anemia