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The impact of intravenous ferric carboxymaltose on renal function: an analysis of
the FAIR-HF study
#MMPMID25683972
Ponikowski P
; Filippatos G
; Colet JC
; Willenheimer R
; Dickstein K
; Lüscher T
; Gaudesius G
; von Eisenhart Rothe B
; Mori C
; Greenlaw N
; Ford I
; Macdougall I
; Anker SD
Eur J Heart Fail
2015[Mar]; 17
(3
): 329-39
PMID25683972
show ga
AIMS: Anaemia and iron deficiency are constituents of the cardio-renal syndrome
in chronic heart failure (CHF). We investigated the effects of i.v. iron in
iron-deficient CHF patients on renal function, and the efficacy and safety of
this therapy in patients with renal dysfunction. METHODS AND RESULTS: The FAIR-HF
trial randomized 459 CHF patients with iron deficiency (ferritin <100?µg/L, or
between 100 and 299?µg/L if transferrin saturation was <20%): 304 to i.v. ferric
carboxymaltose (FCM) and 155 to placebo, and followed-up for 24 weeks. Renal
function was assessed at baseline and at weeks 4, 12, and 24, using the estimated
glomerular filtration rate (eGFR, mL/min/1.73?m(2) ), calculated from the Chronic
Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. At baseline, renal
function was similar between groups (62.4?±?20.6 vs. 62.9?±?23.4 mL/min/1.73?m(2)
, FCM vs. placebo). Compared with placebo, treatment with FCM was associated with
an increase in eGFR [treatment effect: week 4, 2.11?±?1.21 (P = 0.082); week 12,
2.41?±?1.33 (P = 0.070); and week 24, 2.98?±?1.44 mL/min/1.73?m(2) (P = 0.039)].
This effect was seen in all pre-specified subgroups (P > 0.20 for interactions).
No interaction between the favourable effects of FCM and baseline renal function
was seen for the primary endpoints [improvement in Patient Global Assessment (P =
0.43) and NYHA class (P = 0.37) at 24 weeks]. Safety and adverse event profiles
were similar in patients with baseline eGFR <60 and ?60 mL/min/1.73?m(2) .
CONCLUSIONS: Treatment of iron deficiency in CHF patients with i.v. FCM was
associated with an improvement in renal function. FCM therapy was effective and
safe in CHF patients with renal dysfunction.
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