Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency
JAMA,
Год журнала:
2025,
Номер
unknown
Опубликована: Март 30, 2025
Uncertainty
remains
about
the
efficacy
of
intravenous
iron
in
patients
with
heart
failure
and
deficiency.
To
assess
safety
ferric
carboxymaltose
This
multicenter,
randomized
clinical
trial
enrolled
1105
(defined
as
having
a
left
ventricular
ejection
fraction
≤45%)
deficiency
(serum
ferritin
level
<100
ng/mL;
or
if
transferrin
saturation
was
<20%,
serum
between
100
ng/mL
299
ng/mL)
at
70
clinic
sites
6
European
countries
from
March
2017
to
November
2023.
The
median
follow-up
16.6
months
(IQR,
7.9-29.9
months).
Administration
(n
=
558)
initially
given
an
dose
up
2000
mg
that
followed
by
500
every
4
(unless
stopping
criteria
were
met)
vs
saline
placebo
547).
primary
end
point
events
(1)
time
cardiovascular
death
first
hospitalization,
(2)
total
hospitalizations,
(3)
hospitalization
less
than
20%.
All
measured
through
follow-up.
points
would
be
considered
statistically
significant
they
fulfilled
least
1
following
conditions:
P
≤
.05
for
all
3
comparisons,
.025
2
.0167
any
comparisons
(Hochberg
procedure).
Of
participants
(mean
age,
years
[SD,
12
years];
33%
women),
(first
outcome)
occurred
141
group
166
(hazard
ratio,
0.79
[95%
CI,
0.63-0.99];
.04).
second
outcome
(total
hospitalizations)
264
times
320
(rate
0.80
0.60-1.06];
.12).
third
(cardiovascular
<20%)
103
128
0.61-1.02],
.07).
A
similar
amount
had
serious
adverse
event
(269;
48.2%)
(273;
49.9%)
(P
.61).
In
deficiency,
did
not
significantly
reduce
overall
cohort
20%,
number
hospitalizations
placebo.
ClinicalTrials.gov
Identifier:
NCT03036462.
Язык: Английский
Iron Deficiency Treatment in Heart Failure—Challenges and Therapeutic Solutions
Journal of Clinical Medicine,
Год журнала:
2025,
Номер
14(9), С. 2934 - 2934
Опубликована: Апрель 24, 2025
Iron
deficiency
(ID)
is
a
common
comorbidity
in
heart
failure
(HF),
affecting
nearly
50%
of
patients
and
worsening
symptoms,
exercise
capacity,
prognosis.
This
review
summarizes
recent
evidence
from
meta-analyses,
clinical
trials,
guidelines
on
the
pathophysiology,
diagnosis,
treatment
ID
HF.
HF
results
chronic
inflammation,
intestinal
congestion,
impaired
iron
metabolism.
Diagnosis
based
serum
ferritin
transferrin
saturation
(TSAT)
levels.
While
oral
therapy
has
limited
efficacy,
intravenous
iron,
particularly
ferric
carboxymaltose
derisomaltose,
improves
symptoms
tolerance
reduces
hospitalizations.
Timely
diagnosis
are
essential.
Intravenous
preferred
therapeutic
approach,
but
further
research
needed
to
optimize
long-term
management.
Язык: Английский
Ferric carboxymaltose assessment of morbidity and mortality in patients with iron deficiency and chronic heart failure (FAIR‐HF2‐DZHK05) trial: Baseline characteristics and comparison to other relevant clinical trials
European Journal of Heart Failure,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 29, 2025
Aims
Prior
randomized
trials
have
reported
conflicting
evidence
regarding
the
efficacy
of
intravenous
(IV)
iron
in
patients
with
heart
failure
reduced
ejection
fraction
(HFrEF)
and
deficiency
(ID).
Methods
results
FAIR‐HF2
is
a
double‐blind,
randomized,
controlled
trial
evaluating
IV
ferric
carboxymaltose
HFrEF
ID.
We
report
baseline
characteristics
enrolled
compare
them
other
major
(FAIR‐HF,
CONFIRM‐HF,
AFFIRM‐AHF,
IRONMAN,
HEART‐FID).
A
total
1105
were
between
March
2017
November
2023.
Most
men
(67%)
median
age
was
72
(interquartile
range
[IQR]
63–79)
years.
More
than
one‐third
had
hospitalization
within
preceding
12
months
(36%),
53%
hospitalized
at
randomization.
Common
comorbidities
included
hypertension
(79%),
coronary
artery
disease
(74%),
dyslipidaemia
(67%),
diabetes
(46%).
The
left
ventricular
58%
(IQR
42–77)
mean
estimated
glomerular
filtration
rate
58
ml/min/1.73
m
2
.
1064
(96%)
on
renin–angiotensin
system
inhibitors
(angiotensin
receptor–neprilysin
[ARNI]
38%),
1016
(92%)
beta‐blockers,
779
(71%)
mineralocorticoid
receptor
antagonists;
261
(24%)
sodium–glucose
cotransporter
(SGLT2)
inhibitors,
which
much
higher
prior
trials.
proportion
ischaemic
(78%)
compared
to
haemoglobin
(g/dl)
12.7
11.8–13.4),
serum
ferritin
(μg/dl)
63
36–90),
transferrin
saturation
(%)
16.5
11.8–22.9),
resembling
that
6‐min
walk
distance
enrolment
314
±
118
m.
Conclusion
represents
contemporary
cohort
mostly
similar
populations.
Use
SGLT2
ARNI
Clinical
Trial
Registration:
ClinicalTrials.gov
ID
NCT03036462.
Язык: Английский
Recurrent event analyses in patients receiving maintenance dialysis and the effect of higher‐ versus lower‐dose chronic intravenous iron therapy: A report focusing on heart failure events from the PIVOTAL trial
European Journal of Heart Failure,
Год журнала:
2025,
Номер
unknown
Опубликована: Май 20, 2025
Язык: Английский