Docherty, K. F. , McMurray, J. J.V. , Kalra, P., Cleland, J. G.F. , Lang, N. N. , Petrie, M. C. , Robertson, M. and Ford, I. (2024) Intravenous iron and SGLT2 inhibitors in iron-deficient patients with heart failure and reduced ejection fraction. ESC Heart Failure, (doi: 10.1002/ehf2.14742) (Early Online Publication)
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Abstract
Aims: To explore the potential interaction between use of SGLT2 inhibitors and the increase in haemoglobin in patients randomized to intravenous iron or the control group in the IRONMAN (Effectiveness of Intravenous Iron Treatment versus Standard Care in Patients with Heart Failure and Iron Deficiency) trial. Methods and results: This was a post hoc exploratory analysis of the IRONMAN trial which randomized patients with heart failure, a left ventricular ejection fraction (LVEF) ≤ 45% and iron deficiency (transferrin saturation <20% or ferritin <100 μg/L) to open label intravenous ferric derisomaltose or usual care. Of the 1137 randomized patients, 29 (2.6%) were taking an SGLT2 inhibitor at baseline. The mean (SD) change in haemoglobin from baseline at 4 weeks in those taking an SGLT2 inhibitor at baseline was 1.3 (1.2) g/dL in patients randomized to ferric derisomaltose and 0.1 (0.7) g/dL in the usual care group; between-group difference = 1.0 g/dL (95% CI 0.1, 1.8). The equivalent numbers in the no SGLT2 inhibitor group were 0.6 (0.9) g/dL in those randomized to ferric derisomaltose and 0.1 (0.8) g/dL in the usual care group; between-group difference = 0.4 g/dL (95% CI 0.3, 1.6); interaction P value = 0.10. No patient receiving an SGLT2 inhibitor at baseline developed polycythaemia during follow-up (defined as haemoglobin >16.5 g/dL [men] or >16 g/dL [women]). Conclusions: In the IRONMAN trial, there was a trend to a greater increase in haemoglobin with ferric derisomaltose in iron-deficient patients taking an SGLT2 inhibitor at baseline, as compared with those not taking one.
| Item Type: | Articles |
|---|---|
| Additional Information: | IRONMAN was an investigator-initiated trial, designed by members of the TSC (ClinicalTrials.gov identifier: NCT02642562) and funded by the British Heart Foundation (grant award CS/15/1/31175). Pharmacosmos A/S provided and distributed ferric derisomaltose and made an additional contribution to research costs. Drs McMurray, Petrie and Cleland are supported by the British Heart Foundation Centre of Research Excellence Grant RE/18/6/34217. |
| Status: | Early Online Publication |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Docherty, Dr Kieran and Petrie, Professor Mark and Kalra, Professor Paul and Lang, Professor Ninian and Robertson, Mrs Michele and Cleland, Professor John and McMurray, Professor John and Ford, Professor Ian |
| Authors: | Docherty, K. F., McMurray, J. J.V., Kalra, P., Cleland, J. G.F., Lang, N. N., Petrie, M. C., Robertson, M., and Ford, I. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care |
| Journal Name: | ESC Heart Failure |
| Publisher: | Wiley |
| ISSN: | 2055-5822 |
| ISSN (Online): | 2055-5822 |
| Published Online: | 28 March 2024 |
| Copyright Holders: | Copyright © 2024 The Authors |
| First Published: | First published in ESC Heart Failure 2024 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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