The incidence of serious adverse events was similar in the placebo and drug-treated arms, and treatment with darbepoetin alfa showed no evidence of any increases in the events that are of particular concern in patients who receive erythropoietin-type drugs, such as hypertension or thrombotic events.
Supplementation with oral iron in patients with anemia is often ineffective in routine practice, because the supplements taste bad and patients stop taking them, which makes an intravenous supplement an attractive alternative, said Dr. Anker. The results he reported were collected from 18 heart failure patients with anemia (hemoglobin less than 12.5 g/dL) and 17 patients with no anemia (hemoglobin 12.5–14.5 g/dL) but with iron deficiency as measured by their serum ferritin or transferrin saturation levels. Twelve patients from each of these two subgroups were randomized to treatment with weekly infusions of iron sucrose (Venofer), and the remaining 11 were treated with placebo. Patients were treated for 3 months. The study's primary end point was the change from baseline to the end of the study in peak oxygen consumption.
In anemic patients, iron supplementation was associated with a significant 204-mL/min greater increase in oxygen consumption over baseline, compared with the placebo group. In nonanemic patients, supplementation did not lead to a notable change in oxygen consumption, compared with the placebo group, reported Dr. Anker. By other measures, iron supplementation was also linked to improvements in exercise duration and heart failure class. The treatment was also safe, with no difference in adverse event rates between the intervention and control groups.
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