Methods |
RCT; parallel‐group (phase III). Participants were enrolled from 28 sites across 9 countries. |
Participants |
Participants were diagnosed with systolic heart failure, and were treated in an outpatient setting. Participants were required to have iron deficiency as determined by a serum ferritin < 100 ng/mL, or 100‐300 ng/mL where TSAT < 20%. Anaemic patients were not specifically excluded, but the mean Hb of the intervention and control groups was > 120 g/L. |
Interventions |
Participants were randomised to receive IV iron (ferric carboxymaltose) using a bespoke dosing strategy based on Hb and body weight (500‐1000 mg) with repeat dosing at 6 and 12 weeks, or to placebo (equivalent dose of 0.9% sodium chloride). |
Outcomes |
Primary endpoint was change in VO2 peak from baseline to week 24. Secondary endpoints includes effects on Hb, ferritin, TSAT and cardiac biomarkers, QoL and safety endpoints. |
Study funding arrangements |
The study was sponsored by Vifor Pharma, Switzerland. The lead author is an Established Investigator of The Netherlands Heart Foundation. |
Author conflicts of interest |
Multiple study authors received research funding, consultancy fees or honoraria from Vifor Pharma Pty Ltd. Two study authors are employees of Vifor Pharma Pty Ltd. |
Sample size |
A total of 172 participants were studied and randomised 1:1 to receive the intervention (n = 86) or the control (n = 86) treatment. |
Notes |
Study was registered with a public trials register (NCT 01394562). |
Risk of bias |
Bias |
Authors' judgement |
Support for judgement |
Random sequence generation (selection bias) |
Unclear risk |
Comment: no information is given on the process of randomisation or sequence generation. |
Allocation concealment (selection bias) |
Unclear risk |
Comment: no information is given on processes or means of ensuring allocation concealment. |
Blinding of participants and personnel (performance bias)
All outcomes |
High risk |
Comment: this was an open‐label study. Participants and site personnel were not blinded to the group allocation or the intervention |
Blinding of outcome assessment (detection bias)
All outcomes |
Unclear risk |
Comment: whilst VO2 peak was assessed at central laboratory, the clinicians performing the test itself were not blinded. |
Incomplete outcome data (attrition bias)
All outcomes |
Low risk |
Comment: reasons for exclusions were clearly stated, and both full analysis set and per protocol analyses were performed. |
Selective reporting (reporting bias) |
Unclear risk |
Comment: whilst there was complete outcome reporting, some data (notably TSAT and ferritin) were reported as medial only, with no IQR or other variability data included. |
Other bias |
High risk |
Comment: the study was sponsored by Vifor Pharma Pty Ltd, and multiple authors accepted funding from Vifor Pharma Pty Ltd, or are employees of Vifor Pharma Pty Ltd. |