heart rhythmThe 2016 European Society of Cardiology (ESC) Guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) include a strong recommendation for the treatment of iron deficiency with Ferinject in patients with systolic HF.

Iron deficiency is a common comorbidity in HF associated with a worse prognosis. Management of comorbidities is a key component of the holistic care of patients with HF. In Europe, one in two patients with congestive heart failure (CHF) has iron deficiency. Many studies have described iron deficiency, with or without anaemia, as an independent risk factor for mortality, poor exercise capacity and low quality of life.

As per ESC Guidelines HF 2016, ferritin and transferrin saturation (TSAT) are included in the recommended diagnostic tests for the initial assessment of a patient with newly diagnosed HF1. Treatment is recommended when ferritin is <100 µg/L, or ferritin is between 100-299 µg/L and TSAT <20%.

These treatment recommendations are based exclusively on the findings of two double-blind, placebo-controlled clinical trials of Ferinject in patients with CHF and iron deficiency - FAIR-HF and CONFIRM-HF6. The benefits of Ferinject treatment in these studies demonstrated significant improvements in HF symptoms, exercise capacity and quality of life.

The ESC Guidelines HF 2016 also mention that treatment of these patients with Ferinject for up to 52 weeks also showed reduced hospitalisation rates, based on the results of a meta-analysis.

Vifor Pharma welcomed the publication of the updated ESC Guidelines HF 2016. Maureen Cronin, Senior Medical Advisor, said: “We are pleased that the ESC Heart Failure Guidelines 2016 continue to stress the importance of screening and diagnosing Ferinject, and now includes, for the first time, a recommendation for the treatment of iron deficiency specifically with Ferinject, in patients with HF. 

“The guidelines reinforce the wealth of evidence showing Ferinject can significantly improve HF symptoms, exercise capacity and quality of life for these patients, with the potential to reduce hospitalisation.”

Theresa McDonagh, Professor of Heart Failure and Consultant Cardiologist, Kings College London, stated: "Iron deficiency is a debilitating condition which can place a huge burden on a patient's day-to-day life. Approximately 1 out of 2 patients with chronic heart failure have iron deficiency, which is a condition associated with impaired functional capacity, reduced quality of life and a greater risk of mortality." 

HF is one of the most cost-intensive chronic diseases, therefore it is important that treatments for iron deficiency are efficacious and cost-effective. Results from a recent German health-economic analysis of Ferinject in patients with CHF and iron deficiency – also presented at the HFA 2016 congress in Florence – showed that, compared with no iron therapy, treatment with Ferinject demonstrated a minimal net budget impact. Treatment with Ferinject also resulted in improved symptoms and New York Heart Association functional class, and reduced hospitalisation rates, in comparison with no iron therapy.