Abstract 19027: Influence of Intravenous Ferric Carboxymaltose on Health-Related Quality of Life Measures in Patients with Chronic Heart Failure and Iron Deficiency: an Analysis from the FAIR-HF Study
Background: Patients with chronic heart failure (CHF) show impaired health-related quality of life (HRQoL), which is an important target for therapeutic intervention. Impaired iron homeostasis may be one mechanism underlying the poor physical condition of CHF patients. This analysis of the FAIR-HF trial evaluated baseline HRQoL of iron-deficient CHF patients, and the effect of iron repletion using intravenous ferric carboxymaltose (FCM) on HRQoL.
Methods: The FAIR-HF trial randomized 459 CHF patients with impaired left ventricular ejection fraction and iron deficiency with or without anemia, to FCM or placebo (2:1). A total of 449 patients had evaluable HRQoL data at baseline. HRQoL was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the generic EQ-5D questionnaire (Visual Analogue Scale) at baseline and after 4, 12, and 24 weeks of therapy. In both, higher scores mean better HRQoL.
Results: HRQoL was poor at baseline (mean VAS 54.3±16.4; KCCQ overall summary score: 55.9±18.7) compared to previously published, age-matched reference population data (mean VAS: 79.8±17.5). FCM significantly improved HRQoL measures at all time points (mean differences from baseline in KCCQ overall, clinical and total symptom scores: all p<0.001 vs placebo). FCM improved all KCCQ domain mean scores from week 4 (p=0.05), except for the self-efficacy domain. EQ-5D scores also revealed the positive impact of FCM vs placebo on HRQoL. The VAS general health score was improved at weeks 4, 12 and 24 in response to FCM (all p<0.001 vs placebo). FCM resulted in significant improvements in 4 of the 5 EQ-5D dimensions (mobility: p=0.006, self-care: p<0.001, pain/discomfort: p=0.010, anxiety/depression: p=0.016, usual activity: p=0.09, all vs placebo). FCM improved HRQoL in CHF patients both with and without anemia (p-values for interaction: 0.93 [VAS] and 0.66 [KCCQ overall score]).
Conclusions: Health-related quality of life in iron-deficient patients with chronic heart failure is impaired, making it an important therapeutic target. Intravenous ferric carboxymaltose resulted in significant improvements of quality of life during 24 weeks of therapy. The positive effects were seen already after 4 weeks of treatment and were independent of anaemia status.
- © 2010 by American Heart Association, Inc.