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

Ponikowski, P. et al. (2015) The impact of intravenous ferric carboxymaltose on renal function: an analysis of the FAIR-HF study. European Journal of Heart Failure, 17(3), pp. 329-339. (doi: 10.1002/ejhf.229) (PMID:25683972) (PMCID:PMC4413361)

Abstract

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.<p></p> 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 m2), 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 m2, 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 m2 (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 m2.<p></p> 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Greenlaw, Miss Nicola and Ford, Professor Ian
• Authors: Ponikowski, P., Filippatos, G., Colet, J. C., Willenheimer, R., Dickstein, K., Lüscher, T., Gaudesius, G., von Eisenhart Rothe, B., Mori, C., Greenlaw, N., Ford, I., Macdougall, I., and Anker, S. D.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: European Journal of Heart Failure
• Publisher: John Wiley & Sons Ltd.
• ISSN: 1388-9842
• ISSN (Online): 1879-0844
• Copyright Holders: Copyright © 2015 The Authors
• First Published: First published in European Journal of Heart Failure 17(3):329-339
• Publisher Policy: Reproduced under a Creative Commons License