Universität zu Köln

Kramer, Tilmann, Wissmueller, Max, Natsina, Kristiana, Gerhardt, Felix, ten Freyhaus, Henrik, Dumitrescu, Daniel, Viethen, Thomas, Hellmich, Martin, Baldus, Stephan and Rosenkranz, Stephan (2021). Ferric carboxymaltose in patients with pulmonary arterial hypertension and iron deficiency: a long-term study. J. Cachexia Sarcopenia Muscle, 12 (6). S. 1501 - 1513. HOBOKEN: WILEY. ISSN 2190-6009

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Abstract

Background Pulmonary arterial hypertension (PAH) is a progressive disease with limited survival. Iron deficiency (ID) correlates with disease severity and mortality. While oral iron supplementation was shown to be insufficient in such patients, the potential impact of parenteral iron on clinical measures warrants further investigation. Methods We retrospectively analysed the long-term effects of intravenous ferric carboxymaltose (FCM) on iron status and clinical measures in patients with PAH and ID [ferritin < 100 mu g/L or ferritin 100-300 mu g/L and transferrin saturation (TSAT) < 20%] who were on stable targeted PAH therapy, compared with matched controls without ID. Patients with ID received a single infusion of FCM (500 to 1000 mg). Clinical measures monitored included exercise capacity, World Health Organization (WHO) functional class, ESC/ERS risk status, and hospitalizations. The observation period was up to 18 months. Results One hundred and seventeen patients (mean age 60.9 +/- 16.1 years; 64.1% females) with confirmed PAH and on stable targeted therapy for >= 3 months were included (58 with and 59 patients without ID who did not receive FCM). In patients with ID, iron supplementation with FCM resulted in an immediate and sustained improvement of iron status for up to 18 months (serum iron, ferritin, TSAT, all P < 0.01). Fourteen patients in the FCM group received a second FCM infusion after 9.6 +/- 4.8 months due to recurrent ID. At 6 and 18 months after FCM infusion, 6 min walk distance improved from 377.5 +/- 15.9 at baseline to 412.5 +/- 15.1 and 400.8 +/- 14.5 m, respectively (both P < 0.05). WHO functional class (P < 0.05) and ESC/ERS risk status also improved, and there was a reduction of hospitalizations for worsening PAH in the 12 months post vs. prior to iron repletion (P = 0.029). No significant changes were observed in the control group. FCM was well tolerated in all patients, with no severe adverse events. Conclusions In addition to targeted therapy, correction of ID by parenteral iron supplementation with FCM appears feasible and safe, has sustained effects on iron status, and may improve the clinical status and hospitalization rates in patients with PAH. Larger controlled studies are required to confirm this finding.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kramer, Tilmann UNSPECIFIED UNSPECIFIED UNSPECIFIED Wissmueller, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Natsina, Kristiana UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhardt, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Freyhaus, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Dumitrescu, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Viethen, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosenkranz, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-574285
DOI:	10.1002/jcsm.12764
Journal or Publication Title:	J. Cachexia Sarcopenia Muscle
Volume:	12
Number:	6
Page Range:	S. 1501 - 1513
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	2190-6009
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC HEART-FAILURE; EXERCISE CAPACITY; GUIDELINES; HEPCIDIN; PREVALENCE; EXPRESSION; MORBIDITY; DIAGNOSIS; OUTCOMES; THERAPY Multiple languages Geriatrics & Gerontology; Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57428