COPD: IV iron therapy offers some benefits

  • Santer P & al.
  • BMJ Open Respir Res
  • 01/06/2020

  • Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A small randomized controlled trial (RCT) of single-dose intravenous (IV) iron showed improvements in exercise capacity and QoL in patients with nonanemic COPD.
  • The trial did not show improvements in the primary outcome of arterial oxygenation (peripheral oxygen saturation, SpO2).

Why this matters

  • These promising results suggest that a larger RCT is warranted.

Study design

  • Randomized, placebo-controlled, double-blind trial with 48 participants, each receiving a single dose of IV ferric carboxymaltose (FCM: 15 mg/kg body weight) or placebo.
  • Primary outcome was SpO2 at rest after 1 week.
  • Funding: National Institute for Health Research Oxford Biomedical Research Center.

Key results

  • No difference between groups on SpO2 at rest after 1 week.
  • FCM vs placebo yielded greater improvement in exercise capacity, measured by a 6-minute walk distance of 12.6 m (P=.02) overall.
  • At week 1, 29.2% of iron-treated and 0% of placebo-treated participants had improvements of ≥40 m (P=.009).
  • FCM vs placebo was linked to lower scores on functional limitation, assessed using the modified Medical Research Council Dyspnea Scale (33.3% vs 66.7% with scores ≥2; P=.02) at week 1.
  • No difference seen between groups in adverse events, except more frequent hypophosphatemia in the FCM group (91.7% vs 8.3%; P<.001>

Limitations

  • Small sample size.
  • No difference in primary outcome.