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Comparing Ferric Carboxymaltose Versus Iron Sucrose in Patients with Heart Failure

Kazuhiko Kido1

  • 1Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV, USA.

Clinical Cardiology
|July 7, 2026
PubMed

Insights

Ferric carboxymaltose (FCM) effectively repleted iron stores in heart failure (HF) patients with iron deficiency (IDef) more often than iron sucrose. This study highlights FCM as a superior option for iron repletion in this population.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Limited comparative data exists for intravenous (IV) iron products in heart failure (HF) patients with iron deficiency (IDef).
  • Optimal IV iron selection is crucial for managing IDef in HF.
  • Understanding product efficacy aids clinical decision-making.

Purpose of the Study:

  • To compare the efficacy of ferric carboxymaltose (FCM) versus iron sucrose for iron repletion in HF patients.
  • To evaluate IDef therapy goal achievement rates between FCM and iron sucrose.

Main Methods:

  • Retrospective cohort study at a single center.
  • Included patients with HF (reduced/mildly reduced ejection fraction) and IDef receiving FCM or iron sucrose.
  • Primary outcome: IDef therapy goal achievement (defined by ferritin, iron saturation, or hemoglobin levels).

Main Results:

  • Ferric carboxymaltose (FCM) use was associated with significantly higher IDef treatment goal achievement (70.1%) compared to iron sucrose (41.2%) (p=0.026).
  • Adjusted analysis confirmed FCM's superior efficacy (adjusted OR 5.8; p=0.022).
  • No significant difference in adherence to IV iron criteria was observed between groups.

Conclusions:

  • Ferric carboxymaltose (FCM) demonstrated a higher iron repletion rate than iron sucrose in HF patients with IDef.
  • FCM may be a more effective IV iron option for this patient group.
Abstract

Keywords:
ferric carboxymaltoseheart failureintravenous ironiron deficiencyiron sucrose

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