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

Research output: Contribution to journalArticle

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 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.

Details

Authors
  • Piotr Ponikowski
  • Gerasimos Filippatos
  • Josep Comin Colet
  • Ronnie Willenheimer
  • Kenneth Dickstein
  • Thomas Luescher
  • Giedrius Gaudesius
  • Barbara von Eisenhart Rothe
  • Claudio Mori
  • Nicola Greenlaw
  • Ian Ford
  • Iain Macdougall
  • Stefan D. Anker
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • Chronic heart failure, Iron deficiency, Renal function, Ferric, carboxymaltose
Original languageEnglish
Pages (from-to)329-339
JournalEuropean Journal of Heart Failure
Volume17
Issue number3
Publication statusPublished - 2015
Publication categoryResearch
Peer-reviewedYes

Total downloads

No data available