Intravenous Iron Replacement Improves Exercise Tolerance in COPD: A Single-Blind Randomized Trial

Martín-Ontiyuelo, Clara; Rodó-Pin, Anna; Echeverría-Esnal, Daniel; Admetlló, Mireia; Duran, Xavier; Alvarado, Mariela; Gea, Joaquim; Barreiro, Esther; Rodríguez-Chiaradia, Diego A.

doi:10.1016/j.arbres.2021.08.011

Cited by 7 publications

(13 citation statements)

References 48 publications

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“…Among the potential therapeutic strategies, intravenous iron therapy was shown to exert beneficial effects in terms of clinical symptoms and quality of life in patients with chronic heart failure with and without anemia [57]. In the current clinical investigation, intravenous iron therapy was well tolerated in the treated patients, and their clinical symptoms also improved after the trial [35].…”

Section: Discussionmentioning

confidence: 70%

“…In a recent study [35], treatment with iron for four weeks induced a significant improvement in clinical outcomes, including the endurance time of the maximal exercise capacity. Iron replacement for several weeks also elicited beneficial effects in patients with ID anemia, particularly in oxidative stress markers, characterized by a decline after the treatment compared to baseline [36,37].…”

Section: Introductionmentioning

confidence: 95%

“…All the participating patients signed their written informed consent. For more detailed information on the clinical and physiological results, see reference [35].…”

Section: Study Population Design and Ethicsmentioning

confidence: 99%

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Iron Replacement and Redox Balance in Non-Anemic and Mildly Anemic Iron Deficiency COPD Patients: Insights from a Clinical Trial

et al. 2021

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In COPD patients, non-anemic iron deficiency (NAID) is a common systemic manifestation. We hypothesized that in COPD patients with NAID, iron therapy may improve systemic oxidative stress. The FACE (Ferinject assessment in patients with COPD and iron deficiency to improve exercise tolerance) study was a single-blind, unicentric, parallel-group, placebo-controlled clinical trial (trial registry: 2016-001238-89). Sixty-six patients were enrolled (randomization 2:1): iron arm, n = 44 and placebo arm, n = 22, with similar clinical characteristics. Serum levels of 3-nitrotyrosine, MDA-protein adducts, and reactive carbonyls, catalase, superoxide dismutase (SOD), glutathione, Trolox equivalent antioxidant capacity (TEAC), and iron metabolism biomarkers were quantified in both groups. In the iron-treated patients compared to placebo, MDA-protein adducts and 3-nitrotyrosine serum levels significantly declined, while those of GSH increased and iron metabolism parameters significantly improved. Hepcidin was associated with iron status parameters. This randomized clinical trial evidenced that iron replacement elicited a decline in serum oxidative stress markers along with an improvement in GSH levels in patients with stable severe COPD. Hepcidin may be a surrogate biomarker of iron status and metabolism in patients with chronic respiratory diseases. These findings have potential clinical implications in the management of patients with severe COPD.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 95%

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Iron Replacement and Redox Balance in Non-Anemic and Mildly Anemic Iron Deficiency COPD Patients: Insights from a Clinical Trial

et al. 2021

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“…All the participants were diagnosed according to the Global Strategy of Management of COPD patients (GOLD) criteria, in which the following parameters were included: spirometry values, number of exacerbations, and dyspnea score (modified medical research council, mMRC) [ 24 ]. Iron-deficient COPD patients (12 males) presented levels of hemoglobin > 12 g/dL in women and >13 g/dL in men, ferritin < 100 ng/mL, or ferritin 100–299 ng/mL with a transferrin saturation < 20% [ 21 , 23 , 25 , 26 ]. The study was approved on 17 January 2018 by the local Ethics Committee at Hospital del Mar (CEIm Parc de Salut Mar, registration # 2017/7691/I).…”

Section: Methodsmentioning

confidence: 99%

“…Iron deficiency in COPD was also associated with reduced physical activity [ 22 ]. On the other hand, iron replacement improved exercise capacity and QoL in stable COPD patients with decreased iron content [ 23 ]. Studies conducted so far in COPD have focused on the quantification of iron content and regulation in either the blood or the muscle compartment.…”

Section: Introductionmentioning

confidence: 99%

Iron Depletion in Systemic and Muscle Compartments Defines a Specific Phenotype of Severe COPD in Female and Male Patients: Implications in Exercise Tolerance

et al. 2022

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We hypothesized that iron content and regulatory factors, which may be involved in exercise tolerance, are differentially expressed in systemic and muscle compartments in iron deficient severe chronic obstructive pulmonary disease (COPD) patients. In the vastus lateralis and blood of severe COPD patients with/without iron depletion, iron content and regulators, exercise capacity, and muscle function were evaluated in 40 severe COPD patients: non-iron deficiency (NID) and iron deficiency (ID) (20 patients/group). In ID compared to NID patients, exercise capacity, muscle iron and ferritin content, serum transferrin saturation, hepcidin-25, and hemojuvelin decreased, while serum transferrin and soluble transferrin receptor and muscle IRP-1 and IRP-2 increased. Among all COPD, a significant positive correlation was detected between FEV1 and serum transferrin saturation. In ID patients, significant positive correlations were detected between serum ferritin, hepcidin, and muscle iron content and exercise tolerance and between muscle IRP-2 and serum ferritin and hepcidin levels. In ID severe COPD patients, iron content and its regulators are differentially expressed. A potential crosstalk between systemic and muscle compartments was observed in the ID patients. Lung function and exercise capacity were associated with several markers of iron metabolism regulation. Iron status should be included in the overall assessment of COPD patients given its implications in their exercise performance.

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Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach

García‐Río¹,

Miravitlles²,

Soriano³

et al. 2023

Respiratory Medicine

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Intravenous Iron Replacement Improves Exercise Tolerance in COPD: A Single-Blind Randomized Trial

Cited by 7 publications

References 48 publications

Iron Replacement and Redox Balance in Non-Anemic and Mildly Anemic Iron Deficiency COPD Patients: Insights from a Clinical Trial

Iron Replacement and Redox Balance in Non-Anemic and Mildly Anemic Iron Deficiency COPD Patients: Insights from a Clinical Trial

Iron Depletion in Systemic and Muscle Compartments Defines a Specific Phenotype of Severe COPD in Female and Male Patients: Implications in Exercise Tolerance

Dissociation between physical capacity and daily physical activity in COPD patients. A population-based approach

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