NEW YORK (Reuters Health) – Most domains of health-related quality of life in iron-deficient patients with chronic heart failure improve significantly after 4 weeks of treatment with intravenous ferric carboxymaltose, a multicenter team reports in the European Heart Journal online January 31.
“The positive effects of FCM (ferric carboxymaltose) were independent of anaemia status,” note Dr. Josep Comin-Colet, at Hospital del Mar in Barcelona, Spain, and colleagues.
They previously reported results of the FAIR-HF trial showing that ferric carboxymaltose was well tolerated and improved CHF symptoms, exercise capacity and health-related quality of Life (HRQoL) in this patient population. For the current study, they performed a detailed sub-analysis of the effects on different domains of HRQoL.
In the FAIR-HF trial, 459 patients with HYHA class II/III heart failure and serum ferritin levels <100 mcg/L were randomized to FCM or placebo.
HRQoL was assessed after 4, 12 and 24 weeks using two standard instruments: the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) and the generic EuroQoL EQ-5D questionnaire.
Improvements were seen with FCM from the first assessment at 4 weeks. At the final assessment, the percentage of patients reporting improvements was significantly greater with FCM than placebo in all of the five EQ-5D domains (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression), the authors report.
Similarly, five of the seven KCCQ domain scores (physical limitation, symptom burden, symptom frequency, symptom stability, and quality of life), improved significantly with iron treatment compared to placebo; the exceptions were self-efficacy and social limitation.
Furthermore, Dr. Comin-Colet and colleagues found, “The effects of FCM on HRQoL as measured by KCCQ were independent of a range of pre-specified variables, including baseline anaemia, renal function, age, CHF aetiology, and diabetes.”
Summing up, they conclude, “We have shown that iron repletion with FCM over a 24-week period improves generic and disease-specific measures of HRQoL in stable, symptomatic, and ambulatory CHF patients with ID (iron deficiency) and systolic dysfunction.”
The authors add, “Further research is required to confirm these findings and to determine the underlying mechanisms of the efficacy of i.v. iron in patients with ID and CHF.”
