Universität zu Köln

Viethen, Thomas, Gerhardt, Felix, Dumitrescu, Daniel, Knoop-Busch, Susanne, ten Freyhaus, Henrik, Rudolph, Tanja K., Baldus, Stephan and Rosenkranz, Stephan (2014). Ferric carboxymaltose improves exercise capacity and quality of life in patients with pulmonary arterial hypertension and iron deficiency: A pilot study. Int. J. Cardiol., 175 (2). S. 233 - 240. CLARE: ELSEVIER IRELAND LTD. ISSN 1874-1754

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Abstract

Background: Pulmonary arterial hypertension (PAH) is a progressive condition harboring a poor prognosis. Iron deficiency in PAH correlates with disease severity and mortality. While replacement therapy may be beneficial, dietary iron absorption is impaired in PAH patients by hepcidin, a key regulatory protein of iron homoeostasis. We therefore assessed the therapeutic potential and safety of intravenous iron supplementation in patients with PAH and iron deficiency. Methods: 20 patients with PAH and iron deficiency, who were on stable targeted PAH therapy, received a single infusion of <= 1000 mg ferric carboxymaltose. All patients were assessed at baseline and two months after iron treatment. Exercise capacity was evaluated based on the 6-minute- walking distance (6MWD), and quality of life (QoL) was assessed by the SF-36 questionnaire (100 point scale). The effects were compared to 20 matched patients with stable PAH without iron deficiency who did not receive ferric carboxymaltose. Results: In iron deficient patients, iron supplementation led to a marked improvement of iron status (serum iron 5.7 +/- 0.4 to 11.1 +/- 1.1 mu mol/L, ferritin 29.3 +/- 6.3 to 145.2 +/- 25.4 mu g/L, transferrin saturation 7.5 +/- 0.7 to 19.3 +/- 2.3%, all p <= 0.001). Iron-deficient patients receiving ferric carboxymaltose showed a significant increase of the 6MWD from 346.5 +/- 28.3 to 374.0 +/- 25.5 m (p = 0.007), whereas no significant changes were found in the control group not receiving iron supplementation (6MWD 389.9 +/- 25.3 to 379.6 +/- 26.2 m; n.s.), resulting in a net increase in the 6MWD of 37.8 m (p = 0.003). This was associated with an improvement in QoL (SF-36 score from 44.3 +/- 3.7 to 50.6 +/- 3.6; p = 0.01). Only minimal side-effects were reported. Conclusions: These data indicate that parenteral iron supplementation with ferric carboxymaltose significantly improves exercise capacity and QoL and is well tolerated in patients with PAH and iron deficiency, and when administered in addition to targeted PAH therapies. Our results provide proof of concept for further studies evaluating the potential of iron as an adjunct in PAH treatment on a larger scale. (C) 2014 Published by Elsevier Ireland Ltd.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Viethen, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhardt, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Knoop-Busch, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Freyhaus, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-432771
DOI:	10.1016/j.ijcard.2014.04.233
Journal or Publication Title:	Int. J. Cardiol.
Volume:	175
Number:	2
Page Range:	S. 233 - 240
Date:	2014
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1874-1754
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEART-FAILURE; HEPCIDIN EXPRESSION; MUSCLE DYSFUNCTION; EUROPEAN-SOCIETY; TASK-FORCE; GUIDELINES; ASSOCIATION; DIAGNOSIS; METABOLISM; CARDIOLOGY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43277