Baral Tejaswini, Malakapogu Pravachana, Shyma Zuha, Kurian Shilia Jacob, Benson Ruby, Manu Mohan K, Bagchi Debasis, Miraj Sonal Sekhar
Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, KA, India.
Department of Respiratory Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, KA, India.
Nutr Health. 2025 Jun;31(2):407-418. doi: 10.1177/02601060241303814. Epub 2024 Dec 23.
The systematic review summarizes the current evidence on the efficacy and safety of iron replacement in patients with pulmonary hypertension (PH). A systematic literature search was conducted in electronic databases like PubMed, Scopus, Web of Science, and Embase up to April 2024. Eligible studies investigating iron replacement therapy in pulmonary hypertension patients were included in the review. Quality assessment of included studies was performed using standardized risk of bias tools. Five studies met the study-eligible criteria and were included for review. Out of all final selected five studies, one was a randomized control trial (RCT), two were non-RCT, and two were observational studies. We observed an improvement in the six-minute walk distance (6MWD) test, iron indices, peak oxygen intake, and anaerobic threshold after the iron replacement. In all included studies, the iron replacement was tolerated well with no serious adverse events. Regardless of the variation in the study design, positive effects were observed on multiple outcome measures like the 6MWD test, cardiopulmonary exercise test parameter, and iron indices upon iron replacement in PH patients with iron deficiency. Further controlled trials are needed to enable better treatment group comparisons. Exploring long-term impacts on comorbidities, mortality, and disease progression would provide valuable insights for managing pulmonary hypertension.
该系统评价总结了目前关于肺动脉高压（PH）患者铁剂替代治疗的疗效和安全性的证据。截至2024年4月，在PubMed、Scopus、Web of Science和Embase等电子数据库中进行了系统的文献检索。纳入了调查肺动脉高压患者铁剂替代治疗的符合条件的研究。使用标准化的偏倚风险工具对纳入研究进行质量评估。五项研究符合研究纳入标准并被纳入综述。在最终选定的五项研究中，一项是随机对照试验（RCT），两项是非随机对照试验，两项是观察性研究。我们观察到铁剂替代治疗后六分钟步行距离（6MWD）测试、铁指标、峰值摄氧量和无氧阈值有所改善。在所有纳入研究中，铁剂替代治疗耐受性良好，未出现严重不良事件。尽管研究设计存在差异，但在缺铁的肺动脉高压患者中，铁剂替代治疗对多项结局指标如6MWD测试、心肺运动试验参数和铁指标均有积极影响。需要进一步的对照试验以更好地比较治疗组。探索对合并症、死亡率和疾病进展的长期影响将为肺动脉高压的管理提供有价值的见解。
