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@article{Howard:2021:10.1513/AnnalsATS.202009-1131OC,
author = {Howard, LSGE and He, J and Watson, GMJ and Huang, L and Wharton, J and Luo, Q and Kiely, DG and Condliffe, R and Pepke-Zaba, J and Morrell, NW and Sheares, KK and Ulrich, A and Quan, R and Zhao, Z and Jing, X and An, C and Liu, Z and Xiong, C and Robbins, PA and Dawes, T and de, Marvao A and Rhodes, CJ and Richter, MJ and Gall, H and Ghofrani, HA and Zhao, L and Huson, L and Wilkins, MR},
doi = {10.1513/AnnalsATS.202009-1131OC},
journal = {Annals of the American Thoracic Society},
pages = {981--988},
title = {Supplementation with iron in pulmonary arterial hypertension: two randomized crossover trials.},
url = {http://dx.doi.org/10.1513/AnnalsATS.202009-1131OC},
volume = {18},
year = {2021}
}

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TY  - JOUR
AB  - RATIONALE: Iron deficiency, in the absence of anaemia, is common in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) and is associated with a worse clinical outcome. Oral iron absorption may be impeded by elevated circulating hepcidin levels. The safety and benefit of parenteral iron replacement in this patient population is unclear. OBJECTIVES: To evaluate the safety and efficacy of parenteral iron replacement in pulmonary arterial hypertension. METHODS: In two randomised, double blind, placebo-controlled 12 week crossover studies, 39 patients in Europe received a single infusion of ferric carboxymaltose (Ferinject®) 1000 mg (or 15 mg/kg if weight < 66.7Kg) or saline as placebo and 17 patients in China received iron dextran (Cosmofer®) 20 mg iron/kg body weight or saline placebo. All patients had idiopathic or heritable PAH and iron deficiency at entry as defined by: a serum ferritin < 37 µg/l or iron < 10.3 µmol/l or transferrin saturations < 16.4%. RESULTS: Both iron treatments were well tolerated and improved iron status. Analysed separately and combined, there was no effect on any measure of exercise capacity (using cardiopulmonary exercise testing or 6 minute walk test) or cardio-pulmonary haemodynamics, as assessed by right heart catheterisation, cardiac magnetic resonance or plasma NT-proBNP, at 12 weeks. CONCLUSION: Iron repletion by administration of a slow release iron preparation as a single infusion to PAH patients with iron deficiency without overt anaemia was well tolerated but provided no significant clinical benefit at 12 weeks. Clinical trial registered with ClinicalTrials.gov (NCT01447628).
AU  - Howard,LSGE
AU  - He,J
AU  - Watson,GMJ
AU  - Huang,L
AU  - Wharton,J
AU  - Luo,Q
AU  - Kiely,DG
AU  - Condliffe,R
AU  - Pepke-Zaba,J
AU  - Morrell,NW
AU  - Sheares,KK
AU  - Ulrich,A
AU  - Quan,R
AU  - Zhao,Z
AU  - Jing,X
AU  - An,C
AU  - Liu,Z
AU  - Xiong,C
AU  - Robbins,PA
AU  - Dawes,T
AU  - de,Marvao A
AU  - Rhodes,CJ
AU  - Richter,MJ
AU  - Gall,H
AU  - Ghofrani,HA
AU  - Zhao,L
AU  - Huson,L
AU  - Wilkins,MR
DO  - 10.1513/AnnalsATS.202009-1131OC
EP  - 988
PY  - 2021///
SN  - 1546-3222
SP  - 981
TI  - Supplementation with iron in pulmonary arterial hypertension: two randomized crossover trials.
T2  - Annals of the American Thoracic Society
UR  - http://dx.doi.org/10.1513/AnnalsATS.202009-1131OC
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33735594
UR  - https://www.atsjournals.org/doi/10.1513/AnnalsATS.202009-1131OC
UR  - http://hdl.handle.net/10044/1/94216
VL  - 18
ER  -

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