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Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure.
Am J Cardiol. 2018 08 15; 122(4):683-688.AJ

Abstract

Patients with chronic inflammatory conditions including chronic kidney disease (CKD) and heart failure (HF) are undertreated with iron-deficiency anemia (IDA). Progressive inflammation and reduced iron transport associated with CKD and HF may reduce the efficacy of oral iron therapy. Oral ferric citrate improves anemia markers in CKD, but its effects in patients with CKD and concomitant HF have not been described. Patients with CKD not on dialysis and IDA from a phase 2 and 3 trial were treated with ferric citrate (n = 190) or placebo (n = 188); patients with HF were identified from medical histories. Hemoglobin response was defined as a ≥10.0-g/L increase in hemoglobin. Changes in hemoglobin, transferrin saturation, ferritin, and serum phosphate from baseline to week 12 and the incidence of adverse events potentially related to HF were evaluated. HF was reported in 22% (n = 81) of patients. The proportion of patients with hemoglobin response to ferric citrate treatment did not significantly differ in patients with and without HF (43% vs 49%, respectively; p = 0.47); changes from baseline in hemoglobin, iron parameters, and serum phosphate were similar. Adverse events potentially related to HF were noted more frequently in patients with HF (ferric citrate, 23%; placebo, 17%) versus those without HF (ferric citrate, 12%; placebo, 11%). In conclusion, these results indicate a potential role for ferric citrate in the treatment of IDA in patients with CKD not on dialysis and concomitant HF.

Authors+Show Affiliations

Baylor University Medical Center, Baylor Heart and Vascular Hospital, Baylor Heart and Vascular Institute, Dallas, Texas 75246. Electronic address: peteramccullough@gmail.com.Keryx Biopharmaceuticals, Inc., Boston, Massachusetts.Keryx Biopharmaceuticals, Inc., Boston, Massachusetts.Renal Associates PA, San Antonio, Texas.Hofstra Northwell School of Medicine, Great Neck, New York.

Pub Type(s)

Clinical Trial, Phase II
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29961562

Citation

McCullough, Peter A., et al. "Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure." The American Journal of Cardiology, vol. 122, no. 4, 2018, pp. 683-688.
McCullough PA, Uhlig K, Neylan JF, et al. Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure. Am J Cardiol. 2018;122(4):683-688.
McCullough, P. A., Uhlig, K., Neylan, J. F., Pergola, P. E., & Fishbane, S. (2018). Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure. The American Journal of Cardiology, 122(4), 683-688. https://doi.org/10.1016/j.amjcard.2018.04.062
McCullough PA, et al. Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure. Am J Cardiol. 2018 08 15;122(4):683-688. PubMed PMID: 29961562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of Oral Ferric Citrate in Patients With Iron-Deficiency Anemia and Chronic Kidney Disease With or Without Heart Failure. AU - McCullough,Peter A, AU - Uhlig,Katrin, AU - Neylan,John F, AU - Pergola,Pablo E, AU - Fishbane,Steven, Y1 - 2018/05/19/ PY - 2018/02/21/received PY - 2018/04/26/revised PY - 2018/04/30/accepted PY - 2018/7/3/pubmed PY - 2019/8/9/medline PY - 2018/7/3/entrez SP - 683 EP - 688 JF - The American journal of cardiology JO - Am J Cardiol VL - 122 IS - 4 N2 - Patients with chronic inflammatory conditions including chronic kidney disease (CKD) and heart failure (HF) are undertreated with iron-deficiency anemia (IDA). Progressive inflammation and reduced iron transport associated with CKD and HF may reduce the efficacy of oral iron therapy. Oral ferric citrate improves anemia markers in CKD, but its effects in patients with CKD and concomitant HF have not been described. Patients with CKD not on dialysis and IDA from a phase 2 and 3 trial were treated with ferric citrate (n = 190) or placebo (n = 188); patients with HF were identified from medical histories. Hemoglobin response was defined as a ≥10.0-g/L increase in hemoglobin. Changes in hemoglobin, transferrin saturation, ferritin, and serum phosphate from baseline to week 12 and the incidence of adverse events potentially related to HF were evaluated. HF was reported in 22% (n = 81) of patients. The proportion of patients with hemoglobin response to ferric citrate treatment did not significantly differ in patients with and without HF (43% vs 49%, respectively; p = 0.47); changes from baseline in hemoglobin, iron parameters, and serum phosphate were similar. Adverse events potentially related to HF were noted more frequently in patients with HF (ferric citrate, 23%; placebo, 17%) versus those without HF (ferric citrate, 12%; placebo, 11%). In conclusion, these results indicate a potential role for ferric citrate in the treatment of IDA in patients with CKD not on dialysis and concomitant HF. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/29961562/Usefulness_of_Oral_Ferric_Citrate_in_Patients_With_Iron_Deficiency_Anemia_and_Chronic_Kidney_Disease_With_or_Without_Heart_Failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(18)31168-8 DB - PRIME DP - Unbound Medicine ER -