A role for intravenous iron in managing CRAS
Iron deficiency is common in patients with CHF and CKD, and may present a valid therapeutic target in these patient populations.1-3
In patients with CKD, intravenous iron therapy is often used in conjunction with erythropoiesis stimulating agents (ESAs) for the management of anaemia4
In patients with CHF with reduced LVEF, with or without anaemia, the correction of iron status has been shown to improve symptoms and peak oxygen consumption.5-7
Data from the FAIR-HF (Ferric carboxymaltose assessment in patients with iron deficiency and chronic heart failure) study showed that treatment with intravenous ferric carboxymaltose was effective in correcting iron deficiency and is equally beneficial to CHF patients with or without anaemia.8
- These results suggest that iron deficiency rather than anaemia may represent a therapeutic target in patients with CHF.
- If proven, intravenous iron therapy could play a central role in the management of iron deficiency and anaemia in patients with CHF. The potential benefits for outcomes and for quality of life warrant further clinical investigation in patients with CHF and CKD.
References
1. Ezekowitz JA et al. Circulation 2003;107:223–225
2. Nanas JN et al. J Am Coll Cardiol 2006;48:2485–2489
3. Fishbane S et al. Clin J Am Soc Nephrol 2009;4:57–61
4. KDOQI; National Kidney Foundation Am J Kidney Dis 2006;47(suppl 3):S58–70
5. Bolger AP et al. J Am Coll Cardiol 2006;48:1225–1227
6. Okonko DO et al. J Am Coll Cardiol 2008;51:103–112
7. Toblli JE et al. J Am Coll Cardiol 2007;50:1657–1665
8. Anker SD et al. N Engl J Med 2009;361:2436–2448
