Age does not influence ferric derisomaltose treatment outcomes

In the treatment of patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency, the use of ferric derisomaltose appears to result in similar outcomes across age groups, according to data from the open-label IRONMAN trial.

IRONMAN included 1,137 patients (median age 73 years) who were randomly assigned to receive treatment with either ferric derisomaltose (n=569) or usual care (n=568), administered intravenously. The ferric derisomaltose dose given was 20 mg/kg for patients with bodyweight <50 kg, irrespective of haemoglobin; 1,000 mg if bodyweight was 50 to <70 kg and haemoglobin was ≥10 g/dL, or 20 mg/kg if haemoglobin was <10 g/dL; from 20 mg/kg up to a maximum of 1,500 mg if bodyweight was ≥70 kg and haemoglobin was ≥10 g/dL, or 2,000 mg if haemoglobin was <10 g/dL.

The primary outcome was a composite of recurrent heart failure hospitalizations and cardiovascular death, assessed across the following age groups: <67, 67–73, 74–79, and >79 years. Secondary outcomes included changes in haemoglobin and quality of life.

The point estimates for the primary outcome with ferric derisomaltose vs usual care were similar across all age groups: <67 years (rate ratio [RR], 0.87, 95 percent confidence interval [CI], 0.61–1.23), 67–73 years (RR, 0.93, 95 percent CI, 0.66–1.32), 74–79 years (RR, 0.88, 95 percent CI, 0.59–1.33), and >79 years (RR, 0.66, 95 percent CI, 0.45–0.96; p=0.38 for interaction).

Likewise, the improvements in haemoglobin and quality of life at 4 months with ferric derisomaltose were consistent across all age groups (p=0.92 and p=0.64, respectively, for interaction).

Safety outcomes were also similar across age groups, despite older patients being more symptomatic at baseline, with higher N-terminal-pro B-type natriuretic peptide levels and poorer renal function.

The findings support the use of ferric derisomaltose in patients with HFrEF and iron deficiency, including older adults, according to researchers.