Ferric Carboxymaltose fails to reduce hospitalization and death among Heart Failure Patients: JAMA

Researchers have found in a new study that in patients with heart failure and iron deficiency, ferric carboxymaltose did not significantly reduce the time to first heart failure hospitalization or cardiovascular death. Further it did not lower the total number of heart failure hospitalizations compared to a placebo, including in patients with a transferrin saturation below 20%.
Uncertainty remains about the efficacy of intravenous iron in patients with heart failure and iron deficiency. A study was done to assess the efficacy and safety of ferric carboxymaltose in patients with heart failure and iron deficiency.
This multicenter, randomized clinical trial enrolled 1105 patients with heart failure (defined as having a left ventricular ejection fraction of ≤45%) and iron deficiency (serum ferritin level <100 ng/mL; or if transferrin saturation was <20%, a serum ferritin level between 100 ng/mL and 299 ng/mL) at 70 clinic sites in 6 European countries from March 2017 to November 2023.
The median follow-up was 16.6 months (IQR, 7.9-29.9 months). Administration of ferric carboxymaltose (n = 558) initially given at an intravenous dose of up to 2000 mg that was followed by 500 mg every 4 months (unless stopping criteria were met) vs a saline placebo (n = 547). The primary end point events were (1) time to cardiovascular death or first heart failure hospitalization, (2) total heart failure hospitalizations, and (3) time to cardiovascular death or first heart failure hospitalization in patients with a transferrin saturation less than 20%. All end point events were measured through follow-up.
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