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A Prospective Clinical Study of Ferric Citrate Hydrate for Chronic Heart Failure with Iron Deficiency Anemia
Akira Sezai1, Hisakuni Sekino2, Makoto Taoka1
1Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo 173-8610, Japan.
Insights
Oral ferric citrate hydrate effectively treats iron deficiency anemia in chronic heart failure patients, improving key health markers and heart failure biomarkers without significant side effects.
Area of Science:
- Cardiology
- Hematology
- Pharmacology
Background:
- Efficacy of intravenous iron for chronic heart failure (CHF) with iron deficiency is known.
- Oral iron preparations' efficacy in CHF with iron deficiency anemia remains understudied.
Purpose of the Study:
- To evaluate the efficacy and safety of oral ferric citrate hydrate in patients with CHF and iron deficiency anemia.
Main Methods:
- Prospective clinical study involving 141 patients with CHF and iron deficiency anemia.
- Patients received either ferric citrate hydrate or were switched from iron sulfate sustained-release to ferric citrate hydrate.
- Primary endpoint: hemoglobin level; Secondary endpoints: hematocrit, serum iron, transferrin saturation, ferritin, and cardiac/renal/hepatic biomarkers.
Main Results:
- Ferric citrate hydrate significantly increased hemoglobin, serum iron, transferrin saturation (TSAT), and ferritin.
- Significant reductions observed in atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP).
Conclusions:
- Oral ferric citrate hydrate is effective in improving iron metabolism and anemia in CHF patients.
- Treatment led to improvements in heart failure biomarkers and was well-tolerated, with no significant gastrointestinal side effects.
Background:
The efficacy of intravenous iron preparations for chronic heart failure with iron deficiency has been reported, but the efficacy of oral iron preparations has not been demonstrated. In this study, we conducted a prospective clinical study using ferric citrate hydrate tablets in patients with chronic heart failure complicated by iron deficiency anemia.
Methods And Results:
A prospective study was conducted using ferric citrate hydrate in patients with chronic heart failure complicated by iron deficiency anemia. The registered patients were divided into two groups: those administered ferric citrate hydrate and those switched from iron sulfate sustained-release to ferric citrate hydrate. The primary endpoint was hemoglobin level. The secondary endpoints included hematocrit, serum iron, saturation, ferritin, and cardiac-, renal-, and hepatic-related biomarkers. A total of 141 patients were enrolled in this study, including 95 patients who were newly administered ferric citrate hydrate and 46 patients who were switched from iron sulfate sustained-release to ferric citrate hydrate.
Conclusions:
Ferric citrate hydrate significantly increased hemoglobin, serum iron, transferrin saturation (TSAT), and ferritin levels, and decreased atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Ferric citrate hydrate could be continued without side effects such as gastrointestinal symptoms. Improvement in iron metabolism and anemia due to iron supplementation with ferric citrate hydrate led to improvement in heart failure biomarkers.
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