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Tytuł:
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Supplementation with Iron in Pulmonary Arterial Hypertension. Two Randomized Crossover Trials.
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Autorzy:
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Howard LSGE; National Heart and Lung Institute and.; National Pulmonary Hypertension Service, Imperial College Healthcare National Health Service Trust, Hammersmith Hospital, London, United Kingdom.
He J; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Watson GMJ; National Pulmonary Hypertension Service, Imperial College Healthcare National Health Service Trust, Hammersmith Hospital, London, United Kingdom.
Huang L; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Wharton J; National Heart and Lung Institute and.
Luo Q; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Kiely DG; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.; National Pulmonary Hypertension Service, Sheffield Pulmonary Vascular Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Condliffe R; National Pulmonary Hypertension Service, Sheffield Pulmonary Vascular Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Pepke-Zaba J; National Pulmonary Hypertension Service, Royal Papworth Hospital, Cambridge, United Kingdom.
Morrell NW; National Pulmonary Hypertension Service, Royal Papworth Hospital, Cambridge, United Kingdom.
Sheares KK; National Pulmonary Hypertension Service, Royal Papworth Hospital, Cambridge, United Kingdom.
Ulrich A; National Heart and Lung Institute and.
Quan R; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Zhao Z; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jing X; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
An C; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Liu Z; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xiong C; Center of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Robbins PA; Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom.
Dawes T; National Heart and Lung Institute and.
de Marvao A; Medical Research Council London Institute of Medical Sciences, Imperial College London, London, United Kingdom.
Rhodes CJ; National Heart and Lung Institute and.
Richter MJ; Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (Deutsches Zentrum für Lungenforschung), Giessen, Germany; and.
Gall H; Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (Deutsches Zentrum für Lungenforschung), Giessen, Germany; and.
Ghofrani HA; National Heart and Lung Institute and.; Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (Deutsches Zentrum für Lungenforschung), Giessen, Germany; and.; Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Center, Bad Nauheim, Germany.
Zhao L; National Heart and Lung Institute and.
Huson L; National Heart and Lung Institute and.
Wilkins MR; National Heart and Lung Institute and.
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Źródło:
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Annals of the American Thoracic Society [Ann Am Thorac Soc] 2021 Jun; Vol. 18 (6), pp. 981-988.
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Typ publikacji:
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Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Original Publication: New York, NY : American Thoracic Society, [2013]-
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MeSH Terms:
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Anemia, Iron-Deficiency*/drug therapy
Pulmonary Arterial Hypertension*
Cross-Over Studies ; Dietary Supplements ; Double-Blind Method ; Familial Primary Pulmonary Hypertension ; Humans ; Iron ; Treatment Outcome
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References:
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Grant Information:
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RG/10/16/28575 United Kingdom BHF_ British Heart Foundation; FS/15/59/31839 United Kingdom BHF_ British Heart Foundation; MC_UP_1102/19 United Kingdom MRC_ Medical Research Council; CH/09/001/25945 United Kingdom BHF_ British Heart Foundation; PG/18/2/33446 United Kingdom BHF_ British Heart Foundation
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Contributed Indexing:
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Keywords: exercise capacity; ferric carboxymaltose; iron; iron dextran; pulmonary arterial hypertension
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Molecular Sequence:
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ClinicalTrials.gov NCT01447628
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Substance Nomenclature:
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E1UOL152H7 (Iron)
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Entry Date(s):
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Date Created: 20210318 Date Completed: 20210818 Latest Revision: 20230315
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Update Code:
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20240105
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PubMed Central ID:
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PMC8456720
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DOI:
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10.1513/AnnalsATS.202009-1131OC
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PMID:
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33735594
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Rationale: Iron deficiency, in the absence of anemia, is common in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) and is associated with a worse clinical outcome. Oral iron absorption may be impeded by elevated circulating hepcidin concentrations. The safety and benefit of parenteral iron replacement in this patient population is unclear. Objectives: To evaluate the safety and efficacy of parenteral iron replacement in PAH. Methods: In two randomized, double-blind, placebo-controlled 12-week crossover studies, 39 patients in Europe received a single infusion of ferric carboxymaltose (Ferinject) (1,000 mg or 15 mg/kg if weight <66.7 kg) or saline as placebo, and 17 patients in China received iron dextran (Cosmofer) (20 mg iron/kg body weight) or saline placebo. All patients had idiopathic or heritable PAH and iron deficiency at entry as defined by a serum ferritin <37 μg/L or iron <10.3 μmol/L or transferrin saturations <16.4%. Results: Both iron treatments were well tolerated and improved iron status. Analyzed separately and combined, there was no effect on any measure of exercise capacity (using cardiopulmonary exercise testing or 6-minute walk test) or cardiopulmonary hemodynamics, as assessed by right heart catheterization, cardiac magnetic resonance, or plasma NT-proBNP (N-terminal-pro hormone brain natriuretic peptide) at 12 weeks. Conclusions: Iron repletion by administration of a slow-release iron preparation as a single infusion to patients with PAH with iron deficiency without overt anemia was well tolerated but provided no significant clinical benefit at 12 weeks. Clinical trial registered with ClinicalTrials.gov (NCT01447628).
Comment in: Ann Am Thorac Soc. 2021 Jun;18(6):946-948. (PMID: 34076563)
Erratum in: Ann Am Thorac Soc. 2022 Apr;19(4):704. (PMID: 35363128)