Efficacy of ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis

source extracted confidence: high 2026-04-09
#humans #anemia-iron-deficiency #stroke-volume #ventricular-function-left #iron-deficiencies

Efficacy of ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis

Ponikowski et al., 2023 | Eur Heart J | Meta Analysis

Citation

Ponikowski Piotr, Mentz Robert J, ... Anker Stefan D. Efficacy of ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis. Eur Heart J. 2023-Dec-21;44(48):5077-5091. doi:10.1093/eurheartj/ehad586

Abstract

BACKGROUND AND AIMS: Whereas a beneficial effect of intravenous ferric carboxymaltose (FCM) on symptoms and exercise capacity among patients with iron deficiency and heart failure (HF) has been consistently demonstrated, the effects of treatment on clinical events remain the subject of research. This meta-analysis aimed to characterize the effects of FCM therapy on hospitalizations and mortality. METHODS: Patient-level data from randomized, placebo-controlled FCM trials including adults with HF and iron deficiency with ≥52 weeks follow-up were analysed. The co-primary efficacy endpoints were (i) composite of total/recurrent cardiovascular hospitalizations and cardiovascular death and (ii) composite of total HF hospitalizations and cardiovascular death, through 52 weeks. Key secondary endpoints included individual composite endpoint components. Event rates were analysed using a negative binomial model. Treatment-emergent adverse events were also examined. RESULTS: Three FCM trials with a total of 4501 patients were included. Ferric carboxymaltose was associated with a significantly reduced risk of co-primary endpoint 1 (rate ratio 0.86; 95% confidence interval 0.75-0.98; P = .029; Cochran Q: 0.008), with a trend towards a reduction of co-primary endpoint 2 (rate ratio 0.87; 95% confidence interval 0.75-1.01; P = .076; Cochran Q: 0.024). Treatment effects appeared to result from reduced hospitalization rates, not improved survival. Treatment appeared to have a good safety profile and was well tolerated. CONCLUSIONS: In iron-deficient patients with HF with reduced left ventricular ejection fraction, intravenous FCM was associated with significantly reduced risk of hospital admissions for HF and cardiovascular causes, with no apparent effect on mortality.

Key Findings

Three FCM trials with a total of 4501 patients were included. Ferric carboxymaltose was associated with a significantly reduced risk of co-primary endpoint 1 (rate ratio 0.86; 95% confidence interval 0.75-0.98; P = .029; Cochran Q: 0.008), with a trend towards a reduction of co-primary endpoint 2 (rate ratio 0.87; 95% confidence interval 0.75-1.01; P = .076; Cochran Q: 0.024). Treatment effects appeared to result from reduced hospitalization rates, not improved survival. Treatment appeared to ha

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population iron deficiency and heart
Sample Size 4501
Age Range See abstract
Condition deficiency

MeSH Terms

  • Humans
  • Anemia, Iron-Deficiency
  • Stroke Volume
  • Ventricular Function, Left
  • Iron Deficiencies
  • Ferric Compounds
  • Heart Failure
  • Maltose

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Journal Article, Research Support, Non-U.S. Gov't
  • Vertical: iron

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09