Data for the combined analysis were available for 209 patients who received placebo and 266 who received darbepoetin alfa.
The 1-year incidence of death or hospitalization for heart failure was reduced by 33% in the patients treated with darbepoetin, compared with those who received placebo, a difference that neared statistical significance (P = .064).
Darbepoetin alfa treatment was also associated with trends in improved quality of life and in the patients' global self-assessment.
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, Dr. Anker said.
The results that 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 the 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 the nonanemic patients, iron supplementation did not lead to a notable change in oxygen consumption, compared with the placebo group, Dr. Anker reported.
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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