Auryxia (ferric citrate) / Japan Tobacco, Akebia Therap, Averoa - LARVOL DELTA

Ferric Citrate in Iron Deficiency Anemia During Pregnancy (clinicaltrials.gov) - P3 | N=680 | Recruiting | Sponsor: Dhaka Medical College | Not yet recruiting ➔ Recruiting

Enrollment open • Anemia • Hematological Disorders

KKKR-Nephoxil OS-01: Multicenter, Open, Prospective, 48 Weeks, Observational Study ,Evaluate the Safety and Efficacy of Nephoxil Capsule (clinicaltrials.gov) - P=N/A | N=172 | Recruiting | Sponsor: LG Chem | N=100 ➔ 172 | Trial completion date: Dec 2025 ➔ Dec 2028 | Trial primary completion date: Dec 2025 ➔ Feb 2028

Enrollment change • Real-world evidence • Trial completion date • Trial primary completion date • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Efficacy and safety of ferric citrate tablets in Chinese patients with hyperphosphatemia undergoing maintenance hemodialysis: a multicenter, randomized, open-label, active-controlled, phase III trial. (PubMed, Ren Fail) - "Most treatment-emergent adverse events were mild, with gastrointestinal disorders being the most common. Ferric citrate tablets were non-inferior to sevelamer carbonate in reducing serum phosphorus levels in hyperphosphatemia patients on maintenance hemodialysis, with the added benefit of improving iron-related anemia and a favorable safety profile."

Clinical • Journal • Chronic Kidney Disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Metabolic Disorders • Nephrology • Renal Disease

The iron overload caused by non-enzymatically glycated transferrin triggers oxidative stress and ferroptosis by regulating the PI3/AKT signaling pathway and the expression of Nrf2 to promote renal damage in diabetes. (PubMed, Free Radic Biol Med) - "After ferric-citrate addition, intracellular Fe2+ was also higher in the 33.3-Glc-AGE-Tf group than in the 5.6-Glc-AGE-Tf group. Deferoxamine (DFO) or TBHQ (an Nrf-2 activator) ameliorated oxidative stress, iron dysregulation, and ferroptosis in AGE-Tf-treated podocytes and in the kidneys of diabetic rats receiving the WT-Tf vector, whereas LY294002 (a PI3K/AKT pathway inhibitor) primarily alleviated oxidative stress. These findings identify AGE-Tf-associated iron dysregulation as a potential therapeutic target in diabetic kidney disease."

Journal • Diabetes • Diabetic Nephropathy • Hematological Disorders • Hodgkin Lymphoma • Metabolic Disorders • Nephrology • Renal Disease • ACSL4 • GPX4 • SLC7A11

Mechanistic Investigation and Environmental Effects of a Ferric Citrate-Activated Electrokinetic-Persulfate System for Remediation of PCB28-contaminated Soil. (PubMed, Environ Res) - "GC-MS intermediate identification revealed that PCB28 successively underwent dechlorination, biphenyl bond cleavage and hydroxylation, oxidative recombination and aromatic ring opening, complete ring opening and chain saturation processes, and further oxidation during treatment. The EK-PS system activated by ferric citrate can remove PCB28 without damaging the soil, demonstrating practical application potential."

Journal

iRGD-targeted nanoliposomes for hypoxia-relieved sonodynamic and ferroptosis-enhanced chemodynamic combination cancer therapy. (PubMed, Colloids Surf B Biointerfaces) - "In this study, a multifunctional nanoliposome carrier is developed by co-encapsulation of hemoglobin (Hb), ferric citrate (FC), and chlorin e6 (Ce6), and surface-modified with the iRGD (CRGDKGPDC) peptide to facilitate active tumor targeting and enhance subsequent intratumoral penetration...In vivo experimental results show that tail vein injection (i.v.) of iRGD-targeted nanoliposomes combined with external ultrasound irradiation achieves can significantly enhance tumor growth inhibition, which is attributed to triggered on-demand drug release induced by ultrasound. The as-prepared iRGD-targeted nanoliposomes exhibit remarkable synergistic antitumor efficacy, inducing extensive tumor necrosis, apoptosis, and ferroptosis while causing minimal systemic side effects, demonstrating great application potential for future breast cancer therapy."

Journal • Breast Cancer • Oncology • Solid Tumor

Steroid Biosynthesis Pathway Counteracts Iron Overload-Induced Ferroptosis in Mouse Granulosa Cells. (PubMed, Biology (Basel)) - "A mouse model of ovarian iron overload was established by daily gavage of ferric citrate (FC, 120 mg/kg for 40 days)...In cultured KK1 granulosa cells, FC treatment increased intracellular Fe2+ and reactive oxygen species, decreased glutathione content and NADPH/NADP+ ratio, elevated malondialdehyde levels, and induced lipid peroxidation and plasma membrane rupture, all of which were attenuated by the iron chelator deferoxamine...Collectively, these findings demonstrate that iron overload triggers ferroptosis in granulosa cells, leading to follicular arrest and reduced fertility, and that activation of the steroid biosynthesis pathway counteracts ferroptosis, likely through the production of protective intermediates. This study provides a mechanistic basis for iron overload-induced female infertility and identifies the steroid biosynthesis pathway as a potential therapeutic target."

Journal • Preclinical • Gynecology • Hematological Disorders • Infertility • Sexual Disorders • FDFT1 • SREBF2

Emerging Cross-Resistance to Cefiderocol and Ceftazidime-Avibactam in KPC-Producing Klebsiella pneumoniae During Ceftazidime-Avibactam Therapy. (PubMed, Antibiotics (Basel)) - "The presence of ferric citrate transport (FEC) system was also associated with higher FDC MICs. Mutations in genes coding siderophore-iron transporter, PBPs, sensor histidine kinase or Tol-Pal system were also found in some of the isolates. These findings highlight the ability of KPC-Kp to develop co-resistance to both CAZ/AVI and FDC during CAZ/AVI therapy."

Journal • Infectious Disease • Pneumonia

Iron deficiency and iron deficiency anemia (PubMed, Rinsho Ketsueki) - "In recent years, ferric citrate hydrate has been added as a new oral iron preparation, along with ferric carboxymaltose and ferric derisomaltose as new intravenous options. Multiple clinical trials conducted in Japan have expanded the body of evidence. Alongside established agents, iron preparations are contributing to IDA treatment across a broad range of clinical areas."

Journal • Review • Anemia • Hematological Disorders

Effect of Ferric Citrate on ESA and Intravenous Iron Requirements in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis (ERA 2026) - No abstract available

Retrospective data • Review • Chronic Kidney Disease • Nephrology • Renal Disease

The cysteine metabolic regulation through CSE-transsulfuration pathway is essential in iron-induced oxidative damage of heart. (PubMed, Redox Rep) - "We investigated the effects of CSE on oxidative stress, metabolic dysregulation, and cardiac remodeling using in vivo mouse models of chronic iron overload and in vitro ferric citrate (FAC)-treated cardiomyocytes...Mechanistically, CSE deficiency disrupted both cysteine uptake via SLC7A11and cysteine production via transsulfuration pathway, inducing a self-reinforcing cycle of oxidative stress. These findings demonstrate that the CSE-transsulfuration pathway serves as a crucial regulator of cysteine metabolism and antioxidant signaling in cardiomyocytes, presenting a potential therapeutic target in iron-induced cardiomyopathy."

Journal • Cardiomyopathy • Cardiovascular • Fibrosis • Hematological Disorders • Immunology • Metabolic Disorders • GPX4 • HMOX1 • SLC7A11

Copper ions restore antibacterial activity of tigecycline by regulating photodegradation pathway under light exposure‌. (PubMed, Commun Biol) - "We observed that only tigecycline and minocycline, at working concentrations, exhibit a reduction in antibacterial activity under light exposure. Multi-omics technologies revealed that Cu2+-mediated (non-antibacterial) inhibition of bacterial ferric citrate transporter. Animal infection models demonstrated the therapeutic efficacy of copper gluconate-tigecycline under photic conditions, yielding adjuvants for topical formulations and a scientific foundation for photostable tetracycline-based antibiotics."

Journal • Infectious Disease

Iron recovery dynamics after whole blood donation and the effect of low-dose iron supplementation in Japanese donors. (PubMed, Vox Sang) - "Although Hb recovered quickly after 400 mL WB donation, replenishment of iron stores took longer. Low-dose iron supplementation facilitated the recovery of iron stores in women. These findings highlight the need for monitoring iron status and may inform strategies to support donor safety and maintain adequate blood supply."

Journal • Hematological Disorders

Iron acquisition strategies of the rock-inhabiting fungus Knufia petricola reveal vulnerability to chelator-based mitigation. (PubMed, Appl Environ Microbiol) - "Ferric citrate could not be directly assimilated...Its siderophore, although extracellular and allowing chemotropism toward an iron source, cannot obtain iron from strong iron chelators, such as BPS and EDTA. This sensitivity to iron sequestration opens avenues for mitigating the fungal colonization of substrates such as solar panels."

Journal

Dual Expression of Magnetosome-Associated Genes mms6 and magA to Enhance Magnetic Resonance Imaging Contrast in Mammalian Cells. (PubMed, Mol Imaging) - "The cells were supplemented with ferric citrate and imaged using a 3T Siemens Prisma...We evaluated the R2 of the cells co-expressing the two genes with cell lines expressing either gene individually and non-expressing control cells. The result showed dual expression of mms6 and magA lead to a significant increase in R2 and iron uptake compared to cells expressing either gene individually."

Journal • Colorectal Adenocarcinoma • Colorectal Cancer • Oncology • Solid Tumor

Integrative genomic analysis identifies key target genes and candidate drugs for spinal stenosis. (PubMed, Front Mol Neurosci) - "Molecular docking identified six high-affinity compounds: Balsalazide and Eltrombopag for KAT5, Magnesium Citrate and Ferric Citrate for TET2, and Piracetam and Deferiprone for TAF10. These findings elucidate novel genetic and cellular mechanisms underlying spinal stenosis, highlighting the role of TGF-β pathway in disease progression. The identified compounds offer promising therapeutic interventions, bridging genomic discoveries to clinical applications and paving the way for targeted treatment strategies."

Journal • Fibrosis • Immunology • Musculoskeletal Diseases • Orthopedics • TET2 • TGFB1

FIT4KID: Ferric Citrate and Chronic Kidney Disease in Children (clinicaltrials.gov) - P2 | N=160 | Recruiting | Sponsor: University of California, Los Angeles | Trial completion date: Oct 2027 ➔ Nov 2028

Trial completion date • Chronic Kidney Disease • Nephrology • Renal Disease

Dimercaprol Reprograms Intestinal Redox Homeostasis and Organelle Crosstalk to Combat Iron-Induced Gut Dysbiosis Through NRF2/HO-1 Signaling. (PubMed, Antioxidants (Basel)) - "A chronic iron-overload model was established in mice via intragastric gavage of ferric citrate (FC) (286 mg/kg BW) for 16 weeks...These protective effects are mainly caused by the activation of the NRF2/HO-1 pathway, which makes DP a potential therapeutic agent for disorders caused by chronic gut injury induced by FC. DP provides strong protection against iron-induced gut damage by restoring organelle crosstalk, redox homeostasis and microbial-metabolic balance through NRF2/HO-1 signaling."

Journal • Gastrointestinal Disorder • Hematological Disorders • Inflammation • Metabolic Disorders

Safety of Ferric Citrate Hydrate in Pregnant Women With Iron Deficiency Anemia, Fetuses, and Newborns: A Real-World, Observational, Post-Marketing Surveillance Study. (PubMed, J Obstet Gynaecol Res) - "No previously unknown safety concerns were detected in women, fetuses, or newborns by FC treatment during pregnancy."

Journal • Observational data • P4 data • Real-world evidence • Anemia • Constipation • Contact Dermatitis • Dermatitis • Dermatology • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Pain

BIOMARKER CANDIDATES FERRITIN AND FABP3 UNCOVER AN IRON-LIPID AXIS IN MICROGLIA (ADPD 2026) - "Following treatment with iron (iron/ferric citrate) or lipids (cholesterol-rich lipids), microglial phenotypes and secretome profiles were characterized using western blot, qPCR, immunocytochemistry, ELISA, and our novel mass spectrometry-based microglia panel... Our findings highlight the relevance of lipid and iron homeostasis in microglial biology and biomarker interpretation. Furthermore, our data reveal an iron-lipid axis in microglia as lipid treatment induces the release of iron-binding proteins, while iron treatment stimulates the release of FABP3. Increased expression of GPX4 suggests heightened cellular stress and a potential shift toward ferroptotic vulnerability."

Biomarker • Alzheimer's Disease • CNS Disorders • Inflammation • Movement Disorders • Parkinson's Disease • FABP3 • FTH1 • GPX4

Unveiling the synergistic regulation of Co-metabolic substrates and Fe(III) on tetrabromobisphenol A degradation by Geobacter sulfurreducens PCA. (PubMed, J Environ Manage) - "This study investigated the anaerobic degradation of TBBPA by Geobacter sulfurreducens PCA, focusing on the synergistic effects of co-metabolic substrates (glucose and humic acid) and Fe(III) sources (ferric citrate and ferrihydrite)...The discovery of Pathway B highlights the unique capability of G. sulfurreducens PCA to synergistically employ oxidative and reductive mechanisms. These findings provide profound insights into the microbial degradation of TBBPA and offer a strategic framework for optimizing bioremediation in anaerobic environments."

Journal

Safe dosage and potential risks of chlorogenic acid: insights from in vitro and in vivo studies. (PubMed, Front Pharmacol) - "Interestingly, N-Acetyl-L-cysteine (NAC) or ferric citrate reduced hepatocyte toxicity from excessive CGA. The semi-lethal concentration (LD50) for Kunming mice was 382.28 mg/kg. These findings suggest that the antioxidant and iron-chelating properties of CGA determine its role in either liver protection or toxicity at varying concentrations, providing valuable insight for its rational dietary and clinical use."

Journal • Preclinical • Hematological Disorders • Hepatology

Study to Evaluate the Safety and Tolerability of Ferric Citrate in Children With Hyperphosphatemia Related to Chronic Kidney Disease (clinicaltrials.gov) - P3 | N=45 | Suspended | Sponsor: Keryx Biopharmaceuticals | Trial completion date: Oct 2026 ➔ Oct 2027 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease

Ferric Citrate in Iron Deficiency Anemia During Pregnancy (clinicaltrials.gov) - P3 | N=680 | Not yet recruiting | Sponsor: Dhaka Medical College

New P3 trial • Anemia • Hematological Disorders

Ferric citrate for iron deficiency anemia in non-dialysis dependent chronic kidney disease: a randomized phase III study. (PubMed, Kidney Res Clin Pract) - "The most common treatment-related adverse events were gastrointestinal disorders, including diarrhea, discolored feces, abdominal discomfort, constipation, and abdominal pain. PBF-1681 was effective for treating IDA in Taiwanese NDD-CKD patients and had a favorable safety profile."

Journal • P3 data • Anemia • Chronic Kidney Disease • Constipation • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Nephrology • Pain • Renal Disease • FGF23