Key result
Ferric carboxymaltose increases odds of a ≥20m improvement in 6MWT distance by ~116% vs placebo.
Why the study?
Improving functional capacity is a key goal in heart failure, prompting an assessment of the likelihood of improvement or deterioration in 6-minute walk test among iron-deficient HFrEF patients receiving ferric carboxymaltose.
Does ferric carboxymaltose improve 6-minute walk test distance in patients with heart failure with reduced ejection fraction and iron deficiency?
Meta-Analysis (n=760)
Does ferric carboxymaltose improve 6-minute walk test distance in patients with heart failure with reduced ejection fraction and iron deficiency?
Effect estimate: OR 2.16 (95% CI 1.57-2.96)
p-value: p=<0.0001
Ferric carboxymaltose significantly increases the likelihood of clinically meaningful improvements in functional capacity, as measured by the 6-minute walk test, in iron-deficient patients with HFrEF.
Aim Improving functional capacity is a key goal in heart failure (HF). This pooled analysis of FAIR‐HF and CONFIRM‐HF assessed the likelihood of improvement or deterioration in 6‐min walk test (6MWT) among iron‐deficient patients with chronic HF with reduced ejection fraction (HFrEF) receiving ferric carboxymaltose (FCM). Methods and results Data for 760 patients (FCM: n = 454; placebo: n = 306) were analysed. The proportions of patients receiving FCM or placebo who had ≥20, ≥30, and ≥40 m improvements or ≥10 m deterioration in 6MWT at 12 and 24 weeks were assessed. Patients receiving FCM experienced a mean (standard deviation) 31.1 (62.3) m improvement in 6MWT versus 0.1 (77.1) m improvement for placebo at week 12 (difference in mean changes 26.8 [16.6–37.0]). At week 12, the odds [95% confidence interval] of 6MWT improvements of ≥20 m (odds ratio 2.16 [1.57–2.96]; p < 0.0001), ≥30 m (2.00 [1.44–2.78]; p < 0.0001), and ≥40 m (2.29 [1.60–3.27]; p < 0.0001) were greater with FCM versus placebo, while the odds of a deterioration ≥10 m were reduced with FCM versus placebo (0.55 [0.38–0.80]; p = 0.0019). Among patients who experienced 6MWT improvements of ≥20, ≥30, or ≥40 m with FCM at week 12, more than 80% sustained this improvement at week 24. Conclusion Ferric carboxymaltose resulted in a significantly higher likelihood of improvement and a reduced likelihood of deterioration in 6MWT versus placebo among iron‐deficient patients with HF. Of the patients experiencing clinically significant improvements at week 12, the majority sustained this improvement at week 24. These results are supportive of FCM to improve exercise capacity in HF.
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Anker et al. (2022) conducted a meta-analysis in Heart failure with reduced ejection fraction and iron deficiency (n=760). Ferric carboxymaltose vs. Placebo was evaluated on Improvement of ≥20 m in 6-min walk test at 12 weeks (OR 2.16, 95% CI 1.57-2.96, p=<0.0001). Ferric carboxymaltose significantly increased the odds of a ≥20 m improvement in 6-minute walk test distance at 12 weeks compared to placebo (OR 2.16; 95% CI 1.57-2.96; p<0.0001).
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