Efficacy of iron replacement in pulmonary hypertension: A systematic review

Aim: The systematic review summarizes the current evidence on the efficacy and safety of iron replacement in patients with pulmonary hypertension (PH). Methods: 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. Results: 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. Conclusion: 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.