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The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study

Ponikowski, Piotr; Filippatos, Gerasimos; Colet, Josep Comin; Willenheimer, Ronnie LU ; Dickstein, Kenneth; Luescher, Thomas; Gaudesius, Giedrius; von Eisenhart Rothe, Barbara; Mori, Claudio and Greenlaw, Nicola, et al. (2015) In European Journal of Heart Failure 17(3). p.329-339
Abstract
AimsAnaemia 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 resultsThe FAIR-HF trial randomized 459 CHF patients with iron deficiency (ferritin <100 mu g/L, or between 100 and 299 mu g/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/1.73m(2)), calculated from the Chronic Kidney Disease Epidemiology... (More)
AimsAnaemia 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 resultsThe FAIR-HF trial randomized 459 CHF patients with iron deficiency (ferritin <100 mu g/L, or between 100 and 299 mu g/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/1.73m(2)), calculated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. At baseline, renal function was similar between groups (62.420.6 vs. 62.9 +/- 23.4 mL/min/1.73m(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/1.73m(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/1.73m(2). Conclusions<p id="ejhf229-para-0003">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. (Less)
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publication status
published
subject
keywords
Chronic heart failure, Iron deficiency, Renal function, Ferric, carboxymaltose
in
European Journal of Heart Failure
volume
17
issue
3
pages
329 - 339
publisher
Elsevier
external identifiers
  • wos:000351079800013
  • scopus:84924333555
ISSN
1879-0844
DOI
10.1002/ejhf.229
language
English
LU publication?
yes
id
1482951e-8f80-44fa-b883-f04479790085 (old id 5297162)
date added to LUP
2015-05-04 08:31:57
date last changed
2017-11-05 03:03:22
@article{1482951e-8f80-44fa-b883-f04479790085,
  abstract     = {AimsAnaemia 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 resultsThe FAIR-HF trial randomized 459 CHF patients with iron deficiency (ferritin &lt;100 mu g/L, or between 100 and 299 mu g/L if transferrin saturation was &lt;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/1.73m(2)), calculated from the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. At baseline, renal function was similar between groups (62.420.6 vs. 62.9 +/- 23.4 mL/min/1.73m(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/1.73m(2) (P = 0.039)]. This effect was seen in all pre-specified subgroups (P &gt; 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 &lt;60 and 60 mL/min/1.73m(2). Conclusions&lt;p id="ejhf229-para-0003"&gt;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.},
  author       = {Ponikowski, Piotr and Filippatos, Gerasimos and Colet, Josep Comin and Willenheimer, Ronnie and Dickstein, Kenneth and Luescher, Thomas and Gaudesius, Giedrius and von Eisenhart Rothe, Barbara and Mori, Claudio and Greenlaw, Nicola and Ford, Ian and Macdougall, Iain and Anker, Stefan D.},
  issn         = {1879-0844},
  keyword      = {Chronic heart failure,Iron deficiency,Renal function,Ferric,carboxymaltose},
  language     = {eng},
  number       = {3},
  pages        = {329--339},
  publisher    = {Elsevier},
  series       = {European Journal of Heart Failure},
  title        = {The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study},
  url          = {http://dx.doi.org/10.1002/ejhf.229},
  volume       = {17},
  year         = {2015},
}