Cardiology ·
IRONMET-HFpEF Trial Finds Improved Exercise Capacity With Intravenous Iron
In a double-blind, placebo-controlled randomized trial of 65 adults with HFpEF and iron deficiency, a single 1,000-mg dose of ferric derisomaltose improved peak oxygen uptake at 12 weeks. Several other exercise-capacity measures also improved, but health-status scores did not differ significantly between groups.
- Peak oxygen uptake improved versus placebo at 12 weeks.
- Six-minute walk distance and NYHA class also improved.
- Health-status scores did not differ significantly.
- Small trial; clinical-outcome benefit is not established.
Iron deficiency is common in heart failure with preserved ejection fraction (HFpEF) and has been linked to reduced exercise capacity. The IRONMET-HFpEF trial randomized 65 adults with HFpEF and iron deficiency to a single intravenous dose of ferric derisomaltose (1,000 mg; n=44) or placebo (n=21). The double-blind study’s primary endpoint was change in peak oxygen uptake at 12 weeks; 64 participants completed follow-up.
Peak oxygen uptake increased by 1.2 mL/kg/min with ferric derisomaltose and 0.1 mL/kg/min with placebo, for a between-group difference of 1.1 mL/kg/min (95% CI, 0.2–1.9; P=0.02). Oxygen uptake at the anaerobic threshold, six-minute walk distance and NYHA class also improved relative to placebo. The Kansas City Cardiomyopathy Questionnaire overall score did not differ significantly between groups. No serious adverse events related to ferric derisomaltose administration were reported.
The findings suggest a potential improvement in exercise capacity in iron-deficient HFpEF, but the trial was small and follow-up lasted 12 weeks. It did not establish effects on clinical outcomes or show a significant improvement in health-status scores; the results alone do not establish a change in routine care.
In practice
For adults with HFpEF and iron deficiency matching the trial criteria, a single 1,000-mg intravenous dose of ferric derisomaltose improved peak oxygen uptake and several other exercise-capacity measures at 12 weeks compared with placebo. The randomized trial included only 65 participants and did not show a significant between-group difference in health-status scores or establish effects on longer-term clinical outcomes. These findings are promising but do not, on their own, establish a basis for changing routine treatment.
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Circulation: Iron Repletion in Heart Failure With Preserved Ejection Fraction: The IRONMET-HFpEF Randomized Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.