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Indirect comparison between ferric carboxymaltose and oral iron replacement in heart failure with reduced ejection

Edoardo Sciatti1, Ugo Nesti2, Andrea Di Lenarda3

  • 1Cardiology Unit, ASST del Garda, Hospital of Desenzano del Garda (BS). edoardo.sciatti@gmail.com.

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|April 2, 2021
PubMed

Insights

Intravenous ferric carboxymaltose (FCM) is more effective than oral iron for improving exercise capacity in heart failure patients with iron deficiency (ID). FCM shows a trend toward better quality of life, making it the preferred treatment strategy.

Area of Science:

  • Cardiology
  • Hematology
  • Clinical Pharmacology

Background:

  • Iron deficiency (ID) is prevalent in heart failure (HF) patients, impacting symptoms and exercise capacity.
  • Intravenous ferric carboxymaltose (FCM) has shown efficacy in treating ID in HF, while oral iron has been less successful.
  • Direct comparative data between FCM and oral iron for ID in HF is limited.

Purpose of the Study:

  • To conduct an indirect comparison of intravenous ferric carboxymaltose (FCM) versus oral iron for treating iron deficiency (ID) in heart failure (HF) patients.
  • To evaluate the comparative efficacy of FCM and oral iron on exercise capacity and quality of life.

Main Methods:

  • Network meta-analysis of randomized controlled trials (RCTs).
  • Included five studies assessing exercise capacity (6-minute walking test) and quality of life (Kansas City Cardiomyopathy Questionnaire).

Main Results:

  • Ferric carboxymaltose (FCM) demonstrated superior efficacy compared to oral iron in improving exercise capacity.
  • A trend towards improved quality of life was observed with FCM, although not statistically significant in this indirect comparison.
  • Limitations inherent to network meta-analysis were acknowledged.

Conclusions:

  • Intravenous ferric carboxymaltose (FCM) appears to be a more effective strategy than oral iron for correcting iron deficiency (ID) in heart failure (HF) patients.
  • FCM is suggested as the strategy of choice for managing ID in HF, particularly for enhancing exercise capacity.

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