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Iron Isomaltoside/Ferric Derisomaltose vs Iron Sucrose for the Treatment of Iron Deficiency Anemia (IDA)

A Phase III, Randomised, Open-label, Comparative Safety and Efficacy Trial of Intravenous Iron Isomaltoside/Ferric Derisomaltose (Monofer®/Monoferric®) and Iron Sucrose in Subjects With Iron Deficiency Anemia (FERWON-IDA)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02940886
Enrollment
1512
Registered
2016-10-21
Start date
2016-11-08
Completion date
2018-03-28
Last updated
2020-10-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Iron Deficiency Anaemia, Iron Deficiency Anemia

Keywords

Iron Deficiency Anaemia, Iron Deficiency Anemia, IDA, Intravenous iron replacement therapy, Iron isomaltoside, Ferric derisomaltose, Monofer, Monoferric, Monover, Monofar, Monoferro

Brief summary

Evaluate safety and efficacy of iron isomaltoside/ferric derisomaltose (Monofer®/Monoferric®) compared with iron sucrose (Venofer®), in subjects diagnosed with IDA.

Detailed description

IDA is highly prevalent condition in subjects with cancer and gastrointestinal diseases such as inflammatory bowel diseases, menstruating or pregnant women, and subjects who have undergone bariatric procedure or surgery. IDA can have a substantial medical and quality of life (QoL) burden. Treatment of subjects diagnosed with IDA includes controlling the bleeding and replenishing lost iron. This study was designed to evaluate the safety and efficacy of iron isomaltoside/ferric derisomaltose compared with iron sucrose in subjects diagnosed with IDA. In a subfraction of 35 subjects treated with iron isomaltoside/ferric derisomaltose, ECG and iron will be frequently measured. The study subjects received either a single intravenous (IV) dose of iron isomaltoside/ferric derisomaltose (1000 mg at baseline) or iron sucrose (200 mg IV injections at baseline and repeated according to standard practice or physician choice up to a maximum of five times within the first two weeks starting at baseline; a cumulative dose of 1000 mg was recommended). The study subjects were monitored for up to 8 weeks from baseline.

Interventions

Iron isomaltoside/ferric derisomaltose (Monofer®/Monoferric®; 100 mg/mL) was the test product in this trial. The dose of iron isomaltoside/ferric derisomaltose for the individual subject was set to 1000 mg. The dose was diluted in 100 mL 0.9 % sodium chloride (100 mL bags) and administered as a single IV infusion over approximately 20 minutes.

DRUGIron sucrose

Iron sucrose (Venofer®; 20 mg elemental iron/mL) was the comparator in this trial. Iron sucrose was administered as 200 mg undiluted IV injections over approximately 2-5 minutes and repeated according to standard practice or physician choice up to a maximum of five times within the first two weeks starting at baseline. A cumulative dose of 1000 mg was recommended.

Sponsors

Pharmacosmos A/S
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

includes: 1. Men or women ≥ 18 years 2. Subjects having IDA caused by different etiologies 3. Subjects with intolerance to oral iron therapy or a need for rapid repletion of iron stores: 4. Haemoglobin (Hb) ≤ 11 g/dL 5. Transferrin Saturation (TSAT) \< 20 % 6. S-ferritin \< 100 ng/mL 7. Willingness to participate and signing the informed consent form

Exclusion criteria

includes : 1. Anemia predominantly caused by factors other than IDA 2. Hemochromatosis or other iron storage disorders 3. Previous serious hypersensitivity reactions to any IV iron compound 4. Erythropoiesis stimulating agent (ESA) treatment 5. Prior to screening or during the trial period; has or will be treated with a red blood cell transfusion, radiotherapy, and/or chemotherapy 6. Will require a surgical procedure that necessitated general anesthesia prior to screening or during the trial period 7. Alanine aminotransferase and/or aspartate aminotransferase \> 3 times upper limit of normal 8. Required dialysis for treatment of chronic kidney disease (CKD) 9. Alcohol or drug abuse within the past 6 months 10. Pregnant or nursing women

Design outcomes

Primary

MeasureTime frameDescription
Change in Hemoglobin (Hb) From Baseline to Week 8Baseline to week 8Efficacy Evaluate the effect on the hemoglobin (Hb) level following treatment with iron isomaltoside/ferric derisomaltose vs iron sucrose in subjects with iron deficiency anaemia (IDA) . Response was defined as change from baseline in hemoglobin (Hb) to week 8, i.e. ability to increase Hb in subjects with IDA, when oral iron preparations were ineffective or could not be used or in whom the screening Hb measurement in Investigators' opinion were sufficiently low to require rapid repletion of iron stores.
Incidence of Protocol-defined Serious or Severe Hypersensitivity ReactionsBaseline to week 8Safety For this endpoint, the number of participants with serious or severe hypersensitivity reactions were evaluated. The hypersensitivity reactions that were included in the analysis were those that started on or after the first dose of randomised treatment (i.e. treatment emergent). The terms used to define hypersensitivity were those specified by the Standardised MedDRA Queries (SMQ) for hypersensitivity, plus four additional terms: loss of consciousness, seizure, syncope, unresponsiveness. The potential hypersensitivity AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). Results show only those participants that had adjudicated and confirmed serious or severe hypersensitivity reactions.

Secondary

MeasureTime frameDescription
S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8Baseline, week 1, 2, 4, and 8Safety Results show the number of subjects who had s-phosphate \<2 mg/dL at any time from baseline to week 1, 2, 4, or 8.
Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Baseline, week 1, 2, 4, and 8Efficacy Results show responders to the treatment. A subject was considered a Hb responder to a certain week if an increase in Hb of at least 2 g/dL from baseline to the week in question was observed (week 1, 2, 4, and 8).
Time to Change in Hb Concentration ≥2 g/dLBaseline, week 1, 2, 4, and 8Efficacy Time to change in Hb concentration ≥2 g/dL. Subjects who achieved Hb concentration increase of ≥2 g/dL (from baseline to week 1, 2, 4, or 8). For responders, time to Hb response was defined as the scheduled time from baseline until the visit where the first Hb response was measured.
Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8Week 1 to week 8Efficacy Hb concentration of \>12 g/dL at any time from week 1 to week 8. Results show the number of participants who achieved Hb concentration of \>12 g/dL at any time from week 1 to week 8.
Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8Week 1 to week 8Efficacy Results show the number of participants who achieved Hb concentration increase of ≥2 g/dL at any time from week 1 to week 8.
S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8Week 1 to week 8Efficacy Proportion of subjects reaching the composite endpoint of s-ferritin concentration ≥100 ng/mL and TSAT of 20-50% at any time from week 1 to 8.
Change in Hb Concentration From Baseline to Week 1, 2, and 4Baseline, week 1, 2, and 4Efficacy Change in Hb concentration from baseline to week 1, 2, and 4.
Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Baseline, week 1, 2, 4, and 8Efficacy Change in s-ferritin concentration from baseline to weeks 1, 2, 4, and 8.
Composite Cardiovascular Adverse Events (AEs)Baseline, week 1, 2, and 8Safety Results show the composite cardiovascular adverse events (AEs), that started on or after the first dose of randomised treatment (i.e. treatment emergent) up to week 8. The reported potential cardiovascular AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). The potential cardiovascular AEs included the following: * Death due to any cause * Non-fatal myocardial infarction * Non-fatal stroke * Unstable angina requiring hospitalisation * Congestive heart failure requiring hospitalisation or medical intervention * Arrhythmias * Hypertension * Hypotension Results show only those participants that had adjudicated and confirmed treatment-emergent composite cardiovascular AEs.
Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Baseline, week 1, 2, 4, and 8Efficacy Changes in the concentrations of serum iron (s-iron) from baseline to week 1, 2, 4, and 8.
Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8Baseline, week 1, 2, and 8Efficacy Change in fatigue symptoms from baseline to week 1, 2, and 8 was measured by the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. The Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale consisted of 13 items ranging from 0 (not at all) to 4 (very much), except items #7 and #8 which are reversed scored. The total score range is 0-52. A score of less than 30 indicated severe fatigue, and the higher the score, the better outcome/quality of life (QoL). If more than 50% of the items for a subject at a given visit were missing, the total score was not calculated. Total score was calculated as shown below: Total score= Sum of individual scores x 13 / Number of items answered
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And ParkingBaselinePharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by CarBaselinePharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on VisitBaselinePharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsBaselinePharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Health Care Resource Use QuestionnaireBaselinePharmacoeconomics Resources used by the health care staff (per administration), measured by the health care resource use questionnaire. The questionnaire assessed the time used by the health care staff during administration of the investigational product and the administration time (including the observational time). The health care participants included in the evaluation were: investigator, pharmacist, physician, study coordinator, study nurse. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the treatment groups is different (i.e. up to a factor 5 more frequent in the iron sucrose treatment group).
Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Baseline, week 1, 2, 4, and 8Efficacy Changes in transferrin saturation (TSAT) from baseline to week 1, 2, 4, and 8. TSAT is the value of serum iron divided by the total iron-binding capacity and the unit is %, which referrers to % of iron-binding sites of transferrin being occupied by iron.
Time to First Composite Cardiovascular Safety AEBaseline, week 1, 2, 4, and 8Safety Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit. Only the adjudicated and confirmed composite cardiovascular safety AEs, as judged by the CEAC, were considered for this endpoint. Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit.

Countries

United States

Participant flow

Recruitment details

A total of 3108 subjects were screened and 1512 subjects were randomised in the trial.

Pre-assignment details

Subjects who did not have a documented history of intolerance of oral iron for at least 1 month within the last 9 months had a run-in period. During the run-in period, the subject received oral iron for up to 1 month in order to document intolerance or lack of response to oral iron.Subjects were monitored for AEs indicative of iron intolerance.

Participants by arm

ArmCount
Iron Isomaltoside/Ferric Derisomaltose
Iron isomaltoside/ferric derisomaltose, administered IV
1,009
Iron Sucrose
Iron sucrose, administered IV
503
Total1,512

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event73
Overall StudyDeath10
Overall StudyEnrolment error01
Overall StudyLack of Efficacy10
Overall StudyLost to Follow-up4921
Overall StudyNo treatment72
Overall StudyPhysician Decision94
Overall StudyProtocol Violation02
Overall StudySponsor decision01
Overall StudyWithdrawal by Subject2820

Baseline characteristics

CharacteristicIron SucroseIron Isomaltoside/Ferric DerisomaltoseTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
63 Participants107 Participants170 Participants
Age, Categorical
Between 18 and 65 years
440 Participants902 Participants1342 Participants
Age, Continuous43.8 years
STANDARD_DEVIATION 14.4
44.1 years
STANDARD_DEVIATION 14.8
44.0 years
STANDARD_DEVIATION 14.7
Current smoker
NO
423 Participants876 Participants1299 Participants
Current smoker
YES
80 Participants133 Participants213 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
205 Participants387 Participants592 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
298 Participants622 Participants920 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Arabic
2 Participants0 Participants2 Participants
Race/Ethnicity, Customized
Caucasian
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Haitian
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
Hispanic
3 Participants3 Participants6 Participants
Race/Ethnicity, Customized
Latino
0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Mix race (Black & White)
0 Participants3 Participants3 Participants
Race/Ethnicity, Customized
Other (not declared)
2 Participants1 Participants3 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants4 Participants5 Participants
Race (NIH/OMB)
Asian
4 Participants8 Participants12 Participants
Race (NIH/OMB)
Black or African American
223 Participants484 Participants707 Participants
Race (NIH/OMB)
More than one race
0 Participants3 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
2 Participants1 Participants3 Participants
Race (NIH/OMB)
Unknown or Not Reported
9 Participants5 Participants14 Participants
Race (NIH/OMB)
White
264 Participants504 Participants768 Participants
Region of Enrollment
United States
503 participants1009 participants1512 participants
Sex: Female, Male
Female
456 Participants892 Participants1348 Participants
Sex: Female, Male
Male
47 Participants117 Participants164 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 9890 / 494
other
Total, other adverse events
31 / 98916 / 494
serious
Total, serious adverse events
21 / 98913 / 494

Outcome results

Primary

Change in Hemoglobin (Hb) From Baseline to Week 8

Efficacy Evaluate the effect on the hemoglobin (Hb) level following treatment with iron isomaltoside/ferric derisomaltose vs iron sucrose in subjects with iron deficiency anaemia (IDA) . Response was defined as change from baseline in hemoglobin (Hb) to week 8, i.e. ability to increase Hb in subjects with IDA, when oral iron preparations were ineffective or could not be used or in whom the screening Hb measurement in Investigators' opinion were sufficiently low to require rapid repletion of iron stores.

Time frame: Baseline to week 8

Population: Intention to treat (ITT). All randomised subjects.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Iron Isomaltoside/Ferric DerisomaltoseChange in Hemoglobin (Hb) From Baseline to Week 82.49 g/dL
Iron SucroseChange in Hemoglobin (Hb) From Baseline to Week 82.49 g/dL
Comparison: Power:~With N=1000 subjects in the iron isomaltoside/ferric derisomaltose treatment group and with N=500 subjects in the iron sucrose treatment group, assuming no difference between the treatment groups and assuming a common standard deviation (SD) of 1.5 g/dL, the power was 100% for demonstrating non-inferiority of the change in Hb from baseline to week 8, using a non-inferiority margin of -0.5 g/dL.~The significance level was set to 5%.95% CI: [-0.13, 0.13]
Primary

Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions

Safety For this endpoint, the number of participants with serious or severe hypersensitivity reactions were evaluated. The hypersensitivity reactions that were included in the analysis were those that started on or after the first dose of randomised treatment (i.e. treatment emergent). The terms used to define hypersensitivity were those specified by the Standardised MedDRA Queries (SMQ) for hypersensitivity, plus four additional terms: loss of consciousness, seizure, syncope, unresponsiveness. The potential hypersensitivity AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). Results show only those participants that had adjudicated and confirmed serious or severe hypersensitivity reactions.

Time frame: Baseline to week 8

Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseIncidence of Protocol-defined Serious or Severe Hypersensitivity Reactions3 Participants
Iron SucroseIncidence of Protocol-defined Serious or Severe Hypersensitivity Reactions2 Participants
Comparison: Power:~With N=1000 subjects in the iron isomaltoside/ferric derisomaltose, the power was 88% to demonstrate that the upper bound of the 95% CI of the incidence of treatment-emergent serious and/or severe non-serious hypersensitivity AEs was less than 3%.~The significance level was set to 5%.95% CI: [0.06, 0.88]
Comparison: Risk difference between iron isomaltoside/ferric derisomaltose and iron sucrose was assessed for the individual trial with 95% Newcombe CI adjusted for stratum using the Cochran-Mantel-Haenszel method.95% CI: [-0.91, 0.71]
Comparison: Risk difference between iron isomaltoside/ferric derisomaltose and iron sucrose was assessed for the pooled FERWON-IDA and FERWON-NEPHRO trials (2008 subjects treated with iron isomaltoside/ferric derisomaltose and 1000 subjects treated with iron sucrose) with 95% Newcombe CI adjusted for stratum using the Cochran-Mantel-Haenszel method.95% CI: [-0.57, 0.48]
Secondary

Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8

Efficacy Changes in the concentrations of serum iron (s-iron) from baseline to week 1, 2, 4, and 8.

Time frame: Baseline, week 1, 2, 4, and 8

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEAN)Dispersion
Iron Isomaltoside/Ferric DerisomaltoseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 431.2 μg/dLStandard Deviation 49.7
Iron Isomaltoside/Ferric DerisomaltoseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 163.2 μg/dLStandard Deviation 69.7
Iron Isomaltoside/Ferric DerisomaltoseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 238.8 μg/dLStandard Deviation 58.1
Iron Isomaltoside/Ferric DerisomaltoseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 824.2 μg/dLStandard Deviation 53.3
Iron SucroseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 827.6 μg/dLStandard Deviation 32.7
Iron SucroseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 435.1 μg/dLStandard Deviation 33.2
Iron SucroseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 237.0 μg/dLStandard Deviation 51.6
Iron SucroseChange in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8Week 122.4 μg/dLStandard Deviation 44.4
Comparison: Week 1~Change in s-iron from baseline to week 1 was analysed using a Mixed Model for Repeated Measurement (MMRM) including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, including 95% CIs and corresponding p-value.p-value: <0.000195% CI: [38.1, 49.3]Mixed model for repeated measures
Comparison: Week 2~Change in s-iron from baseline to week 2 was analysed using a Mixed Model for Repeated Measurement (MMRM) including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, including 95% CIs and corresponding p-value.p-value: 0.037595% CI: [0.3, 9.8]Mixed model for repeated measures
Comparison: Week 4~Change in s-iron from baseline to week 4 was analysed using a Mixed Model for Repeated Measurement (MMRM) including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, including 95% CIs and corresponding p-value.p-value: 0.602795% CI: [-4, 2.3]Mixed model for repeated measures
Comparison: Week 8~Change in s-iron from baseline to week 8 was analysed using a Mixed Model for Repeated Measurement (MMRM) including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, including 95% CIs and corresponding p-value.p-value: 0.820795% CI: [-2.7, 3.4]Mixed model for repeated measures
Secondary

Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8

Efficacy Change in fatigue symptoms from baseline to week 1, 2, and 8 was measured by the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. The Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale consisted of 13 items ranging from 0 (not at all) to 4 (very much), except items #7 and #8 which are reversed scored. The total score range is 0-52. A score of less than 30 indicated severe fatigue, and the higher the score, the better outcome/quality of life (QoL). If more than 50% of the items for a subject at a given visit were missing, the total score was not calculated. Total score was calculated as shown below: Total score= Sum of individual scores x 13 / Number of items answered

Time frame: Baseline, week 1, 2, and 8

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEAN)Dispersion
Iron Isomaltoside/Ferric DerisomaltoseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 17.98 score on a scaleStandard Deviation 10.41
Iron Isomaltoside/Ferric DerisomaltoseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 210.74 score on a scaleStandard Deviation 11.58
Iron Isomaltoside/Ferric DerisomaltoseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 814.08 score on a scaleStandard Deviation 12.7
Iron SucroseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 211.89 score on a scaleStandard Deviation 11.35
Iron SucroseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 17.38 score on a scaleStandard Deviation 9.38
Iron SucroseChange in Fatigue Symptoms From Baseline to Week 1, 2, and 8Week 815.36 score on a scaleStandard Deviation 12.87
Comparison: Week 1~Change in fatigue symptoms score from baseline to week 1 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline score and baseline score-by-week interaction as covariates.p-value: 0.042295% CI: [0.04, 2.01]Mixed model for repeated measures
Comparison: Week 2~Change in fatigue symptoms score from baseline to week 2 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline score and baseline score-by-week interaction as covariates.p-value: 0.464695% CI: [-1.44, 0.66]Mixed model for repeated measures
Comparison: Week 8~Change in fatigue symptoms score from baseline to week 8 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline score and baseline score-by-week interaction as covariates.p-value: 0.570395% CI: [-1.39, 0.76]Mixed model for repeated measures
Secondary

Change in Hb Concentration From Baseline to Week 1, 2, and 4

Efficacy Change in Hb concentration from baseline to week 1, 2, and 4.

Time frame: Baseline, week 1, 2, and 4

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEAN)Dispersion
Iron Isomaltoside/Ferric DerisomaltoseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 21.49 g/dLStandard Deviation 1.13
Iron Isomaltoside/Ferric DerisomaltoseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 10.70 g/dLStandard Deviation 0.85
Iron Isomaltoside/Ferric DerisomaltoseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 42.15 g/dLStandard Deviation 1.27
Iron SucroseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 10.47 g/dLStandard Deviation 0.69
Iron SucroseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 21.25 g/dLStandard Deviation 0.93
Iron SucroseChange in Hb Concentration From Baseline to Week 1, 2, and 4Week 42.13 g/dLStandard Deviation 1.1
Comparison: Week 1~Change in Hb concentration from baseline to week 1 was analysed using a MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.p-value: <0.000195% CI: [0.19, 0.34]Mixed model for repeated measures
Comparison: Week 2~Change in Hb concentration from baseline to week 2 was analysed using a MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.p-value: <0.000195% CI: [0.19, 0.38]Mixed model for repeated measures
Comparison: Week 4~Change in Hb concentration from baseline to week 4 was analysed using a MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.p-value: 0.109195% CI: [-0.02, 0.2]Mixed model for repeated measures
Secondary

Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8

Efficacy Change in s-ferritin concentration from baseline to weeks 1, 2, 4, and 8.

Time frame: Baseline, week 1, 2, 4, and 8

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEAN)Dispersion
Iron Isomaltoside/Ferric DerisomaltoseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 1373.5 ng/mLStandard Deviation 228.9
Iron Isomaltoside/Ferric DerisomaltoseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 2211.8 ng/mLStandard Deviation 152.4
Iron Isomaltoside/Ferric DerisomaltoseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 498.0 ng/mLStandard Deviation 103.9
Iron Isomaltoside/Ferric DerisomaltoseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 849.0 ng/mLStandard Deviation 79.7
Iron SucroseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 858.7 ng/mLStandard Deviation 104.8
Iron SucroseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 1105.7 ng/mLStandard Deviation 79.1
Iron SucroseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 4109.2 ng/mLStandard Deviation 108.7
Iron SucroseChange in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8Week 2169.9 ng/mLStandard Deviation 129.8
Comparison: Week 1~Change in concentrations of s-ferritin from baseline to week 1 was analysed using a MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: <0.000195% CI: [246.3, 289]Mixed model for repeated measures
Comparison: Week 2~Change in concentrations of s-ferritin from baseline to week 2 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: <0.000195% CI: [25.6, 57.8]Mixed model for repeated measures
Comparison: Week 4~Change in concentrations of s-ferritin from baseline to week 4 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: 0.11595% CI: [-20.3, 2.2]Mixed model for repeated measures
Comparison: Week 8~Change in concentrations of s-ferritin from baseline to week 8 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: 0.081295% CI: [-17.7, 1]Mixed model for repeated measures
Secondary

Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8

Efficacy Changes in transferrin saturation (TSAT) from baseline to week 1, 2, 4, and 8. TSAT is the value of serum iron divided by the total iron-binding capacity and the unit is %, which referrers to % of iron-binding sites of transferrin being occupied by iron.

Time frame: Baseline, week 1, 2, 4, and 8

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEAN)Dispersion
Iron Isomaltoside/Ferric DerisomaltoseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 116.68 percentage of saturationStandard Deviation 15.66
Iron Isomaltoside/Ferric DerisomaltoseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 212.33 percentage of saturationStandard Deviation 13.46
Iron Isomaltoside/Ferric DerisomaltoseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 411.63 percentage of saturationStandard Deviation 12.09
Iron Isomaltoside/Ferric DerisomaltoseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 89.01 percentage of saturationStandard Deviation 12.58
Iron SucroseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 88.87 percentage of saturationStandard Deviation 9.03
Iron SucroseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 15.84 percentage of saturationStandard Deviation 10.52
Iron SucroseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 411.08 percentage of saturationStandard Deviation 8.59
Iron SucroseChange in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8Week 210.58 percentage of saturationStandard Deviation 12.67
Comparison: Week 1~Change in TSAT from baseline to week 1 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: <0.000195% CI: [10.1, 12.7]Mixed model for repeated measures
Comparison: Week 2~Change in TSAT from baseline to week 2 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: 0.000195% CI: [1.2, 3.6]Mixed model for repeated measures
Comparison: Week 4~Change in TSAT from baseline to week 4 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: 0.016295% CI: [0.2, 2.1]Mixed model for repeated measures
Comparison: Week 8~Change in TSAT from baseline to week 8 was analysed using MMRM including treatment, week, treatment-by-week interaction, and strata as factors and baseline value and baseline value-by-week interaction as covariates.~The estimated treatment differences based on the least square means of the treatment-by-week interaction effects are presented by week, include 95% CIs and corresponding p-value.p-value: 0.056995% CI: [0, 1.8]Mixed model for repeated measures
Secondary

Composite Cardiovascular Adverse Events (AEs)

Safety Results show the composite cardiovascular adverse events (AEs), that started on or after the first dose of randomised treatment (i.e. treatment emergent) up to week 8. The reported potential cardiovascular AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). The potential cardiovascular AEs included the following: * Death due to any cause * Non-fatal myocardial infarction * Non-fatal stroke * Unstable angina requiring hospitalisation * Congestive heart failure requiring hospitalisation or medical intervention * Arrhythmias * Hypertension * Hypotension Results show only those participants that had adjudicated and confirmed treatment-emergent composite cardiovascular AEs.

Time frame: Baseline, week 1, 2, and 8

Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseComposite Cardiovascular Adverse Events (AEs)8 Participants
Iron SucroseComposite Cardiovascular Adverse Events (AEs)6 Participants
Comparison: Adjudicated and confirmed treatment-emergent composite cardiovascular AEs. Any treatment emergent composite cardiovascular AEs were included in the statistical evaluation. The overall incidence of adjudicated and confirmed composite cardiovascular AEs was tabulated and compared between the treatment groups by a Fisher's exact test.p-value: 0.5695Fisher Exact
Secondary

Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8

Efficacy Results show the number of participants who achieved Hb concentration increase of ≥2 g/dL at any time from week 1 to week 8.

Time frame: Week 1 to week 8

Population: ITT. All randomised subjects.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8687 Participants
Iron SucroseHb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8340 Participants
Comparison: The proportion of subjects who achieved an increase in Hb concentration ≥2 g/dL at any time from week 1 to week 8 was analysed using a logistic regression model with treatment and strata as fixed effects.~The estimated treatment ratio of iron isomaltoside/ferric derisomaltose versus iron sucrose was presented with 95% CI and corresponding p-value.p-value: 0.874695% CI: [0.81, 1.28]Regression, Logistic
Secondary

Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8

Efficacy Results show responders to the treatment. A subject was considered a Hb responder to a certain week if an increase in Hb of at least 2 g/dL from baseline to the week in question was observed (week 1, 2, 4, and 8).

Time frame: Baseline, week 1, 2, 4, and 8

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 151 Participants
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 2297 Participants
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 4514 Participants
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 8606 Participants
Iron SucroseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 8309 Participants
Iron SucroseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 112 Participants
Iron SucroseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 4250 Participants
Iron SucroseHb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8Responder YES week 294 Participants
Comparison: Week 1~Hb increase of ≥2 g/dL from baseline to week 1.~Proportion of Hb responders to each week was analysed using a repeated measures logistic regression model with treatment, visit, strata, and treatment by visit interaction as fixed effects and baseline value as covariate.p-value: 0.007795% CI: [1.27, 4.72]Repeated measures logistic regressioin
Comparison: Week 2~Hb increase of ≥2 g/dL from baseline to week 2.~Proportion of Hb responders to each week was analysed using a repeated measures logistic regression model with treatment, visit, strata, and treatment by visit interaction as fixed effects and baseline value as covariate.p-value: <0.000195% CI: [1.8, 3.26]Repeated measures logistic regressioin
Comparison: Week 4~Hb increase of ≥2 g/dL from baseline to week 4.~Proportion of Hb responders to each week was analysed using a repeated measures logistic regression model with treatment, visit, strata, and treatment by visit interaction as fixed effects and baseline value as covariate.p-value: 0.104995% CI: [0.96, 1.58]Repeated measures logistic regressioin
Comparison: Week 8~Hb increase of ≥2 g/dL from baseline to week 8.~Proportion of Hb responders to each week was analysed using a repeated measures logistic regression model with treatment, visit, strata, and treatment by visit interaction as fixed effects and baseline value as covariate.p-value: 0.703295% CI: [0.8, 1.38]Repeated measures logistic regressioin
Secondary

Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8

Efficacy Hb concentration of \>12 g/dL at any time from week 1 to week 8. Results show the number of participants who achieved Hb concentration of \>12 g/dL at any time from week 1 to week 8.

Time frame: Week 1 to week 8

Population: ITT. All randomised subjects.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseHb Concentration of >12 g/dL at Any Time From Week 1 to Week 8484 Participants
Iron SucroseHb Concentration of >12 g/dL at Any Time From Week 1 to Week 8225 Participants
Comparison: The proportion of subjects who achieved a Hb level of \>12 g/dL at any time from week 1 to week 8 was analysed using a logistic regression model with treatment and strata as fixed effects. The estimated treatment ratio of iron isomaltoside/ferric derisomaltose versus iron sucrose is presented with 95% CI and corresponding p-value.p-value: 0.24295% CI: [0.92, 1.41]Regression, Logistic
Secondary

Health Care Resource Use Questionnaire

Pharmacoeconomics Resources used by the health care staff (per administration), measured by the health care resource use questionnaire. The questionnaire assessed the time used by the health care staff during administration of the investigational product and the administration time (including the observational time). The health care participants included in the evaluation were: investigator, pharmacist, physician, study coordinator, study nurse. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the treatment groups is different (i.e. up to a factor 5 more frequent in the iron sucrose treatment group).

Time frame: Baseline

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseHealth Care Resource Use QuestionnaireTime spent per site staff median1.08 hours
Iron Isomaltoside/Ferric DerisomaltoseHealth Care Resource Use QuestionnaireTime spent per subject median3.38 hours
Iron SucroseHealth Care Resource Use QuestionnaireTime spent per site staff median1.00 hours
Iron SucroseHealth Care Resource Use QuestionnaireTime spent per subject median3.00 hours
Secondary

Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking

Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).

Time frame: Baseline

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And ParkingCost of public transport/taxi5.0 US dollars ($)
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And ParkingCost of parking0.0 US dollars ($)
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And ParkingCost of public transport/taxi5.0 US dollars ($)
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And ParkingCost of parking0.0 US dollars ($)
Secondary

Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits

Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).

Time frame: Baseline

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (NUMBER)
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsIn employment, YES529 participants
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsTook time off work to attend, YES233 participants
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsAssistance by others to attend visit, YES211 participants
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsOthers took time off work to attend, YES64 participants
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsOthers took time off work to attend, YES32 participants
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsIn employment, YES258 participants
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsAssistance by others to attend visit, YES111 participants
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend VisitsTook time off work to attend, YES113 participants
Secondary

Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car

Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).

Time frame: Baseline

Population: ITT. All randomised subjects.

ArmMeasureValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car15.0 miles
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car15.0 miles
Secondary

Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit

Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).

Time frame: Baseline

Population: ITT. All randomised subjects.

ArmMeasureGroupValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on VisitTime spent on visit2.0 Hours
Iron Isomaltoside/Ferric DerisomaltoseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on VisitTotal time spent helping on visit2.0 Hours
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on VisitTime spent on visit2.0 Hours
Iron SucroseIntervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on VisitTotal time spent helping on visit2.0 Hours
Secondary

S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8

Efficacy Proportion of subjects reaching the composite endpoint of s-ferritin concentration ≥100 ng/mL and TSAT of 20-50% at any time from week 1 to 8.

Time frame: Week 1 to week 8

Population: ITT. All randomised subjects.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseS-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8680 Participants
Iron SucroseS-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8164 Participants
Comparison: Proportion of subject who achieved a s-ferritin level of ≥100 ng/mL AND a TSAT of 20-50% at any time from week 1 to week 8 was analysed using a logistic regression model with treatment and strata as fixed effects.~The estimated treatment ratio of iron isomaltoside/ferric derisomaltose versus iron sucrose is presented with 95% CI and corresponding p-value.p-value: <0.000195% CI: [3.58, 5.71]Regression, Logistic
Secondary

S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8

Safety Results show the number of subjects who had s-phosphate \<2 mg/dL at any time from baseline to week 1, 2, 4, or 8.

Time frame: Baseline, week 1, 2, 4, and 8

Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Iron Isomaltoside/Ferric DerisomaltoseS-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 838 Participants
Iron SucroseS-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 811 Participants
Secondary

Time to Change in Hb Concentration ≥2 g/dL

Efficacy Time to change in Hb concentration ≥2 g/dL. Subjects who achieved Hb concentration increase of ≥2 g/dL (from baseline to week 1, 2, 4, or 8). For responders, time to Hb response was defined as the scheduled time from baseline until the visit where the first Hb response was measured.

Time frame: Baseline, week 1, 2, 4, and 8

Population: ITT. All randomised subjects.

ArmMeasureValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseTime to Change in Hb Concentration ≥2 g/dL28 Days
Iron SucroseTime to Change in Hb Concentration ≥2 g/dL28 Days
Comparison: Time to Hb response was estimated using the Kaplan-Meier method and the hypothesis of no treatment difference was assessed by a 2-sided log-rank test.p-value: 0.088Log Rank
Secondary

Time to First Composite Cardiovascular Safety AE

Safety Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit. Only the adjudicated and confirmed composite cardiovascular safety AEs, as judged by the CEAC, were considered for this endpoint. Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit.

Time frame: Baseline, week 1, 2, 4, and 8

Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.

ArmMeasureValue (MEDIAN)
Iron Isomaltoside/Ferric DerisomaltoseTime to First Composite Cardiovascular Safety AENA Week
Iron SucroseTime to First Composite Cardiovascular Safety AENA Week
Comparison: The time to first adjudicated and confirmed composite cardiovascular AEs was estimated using the Kaplan-Meier method and the hypothesis of no treatment difference was assessed by a log-rank test.p-value: 0.3913Log Rank

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026