Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .
Effect of Ferric Carboxymaltose on Exercise Capacity in Patients With Chronic Heart Failure and Iron Deficiency
Background : Iron deficiency is common in patients with heart failure ( HF ) and is associated with reduced exercise capacity and poor outcomes . Whether correction of iron deficiency with ( intravenous ) ferric carboxymaltose ( FCM ) affects peak oxygen consumption [ peak VO2 ] , an objective measure of exercise intolerance in HF , has not been examined . Methods : We studied patients with systolic HF ( left ventricular ejection fraction ⩽45 % ) and mild to moderate symptoms despite optimal HF medication . Patients were r and omized 1:1 to treatment with FCM for 24 weeks or st and ard of care  . The primary end point was the change in peak VO2 from baseline to 24 weeks . Secondary end points included the effect on hematinic and cardiac biomarkers , quality of life , and safety . For the primary analysis , patients who died had a value of 0 imputed for 24-week peak VO2 . Additional sensitivity analyses were performed to determine the impact of imputation of missing peak VO2 data . Results : A total of 172 patients with HF were studied and received FCM ( n=86 ) or st and ard of care ( control group , n=86 ) . At baseline , the groups were well matched ; mean age was 64 years , 75 % were male , mean left ventricular ejection fraction was 32 % , and peak VO2 was 13.5 mL/min/kg  . FCM  significantly increased serum ferritin and transferrin saturation . At 24 weeks , peak VO2 had decreased in the control group ( least square means −1.19±0.389 mL/min/kg ) but was maintained on FCM ( −0.16±0.387 mL/min/kg ; P=0.020 between groups ) . In a sensitivity analysis , in which missing data were not imputed , peak VO2 at 24 weeks decreased by −0.63±0.375 mL/min/kg in the control group and by −0.16±0.373 mL/min/kg in the FCM group ; P=0.23 between groups ) . Patients ’ global assessment and functional class as assessed by the New York Heart Association improved on FCM versus st and ard of care . Conclusions : Treatment with intravenous FCM in patients with HF and iron deficiency  improves iron stores . Although a favorable effect on peak VO2 was observed on FCM , compared with st and ard of care in the primary analysis , this effect was highly sensitive to the imputation strategy for peak VO2 among patients who died . Whether FCM is associated with an improved outcome in these high-risk patients needs further study . Clinical Trial Registration : URL : http://www . clinical trials.gov . Unique identifier : NCT01394562
Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .