Oral Iron Therapy with Polysaccharide-Iron Complex May be Useful in Increasing the Ferritin Level for a Short Time in Patients with Dilated Cardiomyopathy

Background: Iron deficiency (ID) is one of the most common comorbidities in patients with heart failure (HF). The preferred form of iron supplementation is intravenously. Polysaccharide-iron complex (PIC) is an oral iron supplement that has a bioavailability of 100%; gastrointestinal complaints are absent or less frequent with PICs. Objectives: In this study we aimed to investigate if oral PIC was effective at increasing the ferritin level over 12 weeks in dilated cardiomyopathy patients with an absolute iron deficiency and to determine the incidence GI side effects with this type of treatment. Methods: Thirty patients with a diagnosis of non-ischemic dilated cardiomyopathy (left ventricular ejection fraction (LVEF) < 35%) and absolute iron deficiency (serum ferritin level < 100 mcg/L) were recruited. For all study participants, one capsule of Feramax-150 was prescribed on a daily basis for 12 weeks. All patients were asked to report any GI side effects, including heartburn, abdominal pain, nausea, vomiting, diarrhea, constipation, and bloating. Results: The mean (SD) age was 43.2 (13.4) years. The mean LVEF was 23%. The mean(SD) ferritin level was 48.8 (27.7) at baseline. After 12 weeks of treatment with Feramax-150, the mean(SD) ferritin level had increased to 69.9 (42) (P< 0.001). No patients reported any gastrointestinal side effects. Conclusions: PICs could be a good and well-tolerated medicine in the treatment of iron deficiency in patients with heart failure. It is recommended that PICs be prescribed to maintain body iron stores after IV iron therapies in HF patients.