***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Aim The aim of this study was to evaluate the benefits and safety of long-term i.v . iron therapy in iron-deficient patients with heart failure ( HF ) . Methods and results CONFIRM-HF was a multi-centre , double-blind , placebo-controlled trial that enrolled 304 ambulatory symptomatic HF patients with left ventricular ejection fraction ≤45 % , elevated natriuretic peptides , and iron deficiency ( ferritin < 100 ng/mL or 100–300 ng/mL if transferrin saturation < 20 % ) . Patients were r and omized 1 : 1 to treatment with i.v . iron , as ferric carboxymaltose ( FCM , n = 152 ) or placebo ( saline , n = 152 ) for 52 weeks . The primary end-point was the change in 6-min-walk-test ( 6MWT ) distance from baseline to Week 24 . Secondary end-points included changes in New York Heart Association ( NYHA ) class , Patient Global Assessment ( PGA ) , 6MWT distance , health-related quality of life ( QoL ) , Fatigue Score at Weeks 6 , 12 , 24 , 36 , and 52 and the effect of FCM on the rate of hospitalization for worsening HF . Treatment with FCM significantly prolonged 6MWT distance at Week 24 ( difference FCM vs. placebo : 33 ± 11 m , P = 0.002 ) . The treatment effect of FCM was consistent in all subgroups and was sustained to Week 52 ( difference FCM vs. placebo : 36 ± 11 m , P < 0.001 ) . Throughout the study , an improvement in NYHA class , PGA , QoL , and Fatigue Score in patients treated with FCM was detected with statistical significance observed from Week 24 onwards . Treatment with FCM was associated with a significant reduction in the risk of hospitalizations for worsening HF [ hazard ratio ( 95 % confidence interval ) : 0.39 ( 0.19–0.82 ) , P = 0.009 ] . The number of deaths ( FCM : 12 , placebo : 14 deaths ) and the incidence of adverse events were comparable between both groups . Conclusion Treatment of symptomatic , iron-deficient HF patients  with FCM over a 1-year period result ed in sustainable improvement in functional capacity , symptoms , and QoL and may be associated with risk reduction of hospitalization for worsening HF ( Clinical Trials.gov number NCT01453608 ) BACKGROUND Despite preoperative anaemia treatment , a risk of postoperative anaemia remains . This r and omized , controlled study evaluated the efficacy of i.v . ferric carboxymaltose ( FCM ) as postoperative anaemia treatment after total knee arthroplasty ( TKA ) . METHODS TKA patients with postoperative anaemia [ haemoglobin ( Hb ) 8.5 - 12.0 g dl(-1 ) ] without prior transfusions were r and omly assigned to FCM [ 700 - 1000 mg iron ( according to calculate iron deficit on postoperative day 2 ) ] or ferrous glycine sulphate ( FS ; 100 mg iron daily from day 7 onwards ) and followed for Hb , iron status , quality -of-life ( EQ-5D ) , and performance ( 6 min walk test ) until day 30 . RESULTS Of 161 preoperatively non-anaemic patients , 122 ( 75.8 % ) developed anaemia after operation ( within 24 h ) and were enrolled in this study ( 60 FCM , 62 FS ) . Hb substantially decreased until day 4 in both groups , and partly recovered by day 30 . FCM-treated patients achieved Hb ≥12.0 g dl(-1 ) more frequently ( 42.3 % vs 23.5 % ; P=0.04 ) and showed a trend towards higher Hb increase from day 4 to day 30 [ + 1.7 ( 1.2 ) vs + 1.3 ( 1.0 ) ; P=0.075 ] compared with FS-treated patients . Patients with postoperative Hb < 10 g dl(-1 ) experienced better Hb increase with FCM [ + 2.4 ( 0.3 ) g dl(-1 ) ] than FS [ + 1.1 ( 0.4 ) g dl(-1 ) ; P=0.018 ] . Patients being iron-deficient at enrolment ( 56.7 % ) had a higher Hb increase with FCM [ + 1.9 ( 0.3 ) g dl(-1 ) ] than FS [ + 1.2 ( 0.2 ) g dl(-1 ) ; P=0.03 ] . Total EQ-5D and performance outcomes were comparable between the groups , but FCM was associated with better scores for ' usual activities ' . No i.v . iron-related adverse events were reported . CONCLUSIONS Preoperatively non-anaemic TKA patients are at high risk of postoperative anaemia . Postoperative i.v . FCM provided significant benefit over oral FS , particularly in patients with preoperative iron deficiency , severe postoperative  anaemia , or both . CLINICAL TRIAL REGISTRATION EudraCT 2010 - 023038 - 22 ; Clinical Trials.gov NCT01913808 We conducted a r and omized study analyzing the impact of darbepoetin alfa ( DA ) administration with or without intravenous ( i.v . ) iron on erythroid recovery after autologous hematopoietic cell transplantation ( HCT ) . Patients were r and omized between no DA ( Arm 1 ) , DA 300 μg every 2 weeks starting on Day 28 after HCT ( Arm 2 ) , or DA plus i.v . iron 200 mg on Days 28 , 42 , and 56 ( Arm 3 ) . The proportion achieving complete hemoglobin ( Hb ) response within 18 weeks ( primary end point ) was 21 % in Arm 1 ( n = 24 ) , 79 % in Arm 2 ( n = 25 ) , and 100 % in Arm 3 ( n = 23 ; P < 0.0001 ) . Erythropoietic response was shown to be significantly higher in Arm 3 ( n = 46 ) than in Arm 2 ( n = 50 ; P = 0.008 ) , result ing in lower DA use , reduced drug costs , and improved quality of life scores , but the effect on transfusions was not significant . In multivariate analysis , DA administration ( P < 0.0001 ) , i.v . iron administration ( P = 0.0010 ) , high baseline Hb ( P < 0.0001 ) , and low baseline creatinine ( P = 0.0458 ) were independently associated with faster achievement of complete Hb response . In conclusion , DA is highly effective to ensure full erythroid reconstitution after autologous HCT when started on Day 28 post‐transplant . I.v . iron sucrose further improves erythroid recovery . Am . J. Hematol . 88:990–996 , 2013 . © 2013 Wiley Periodicals , PURPOSE To evaluate the safety and efficacy of intravenous ( IV ) sodium ferric gluconate complex ( FG ) , oral ferrous sulfate , or no iron to increase hemoglobin ( Hb ) in anemic cancer patients receiving chemotherapy and epoetin alfa .  PATIENTS AND METHODS In this open-label , multicenter trial , 187 patients with chemotherapy-related anemia ( Hb < 11 g/dl ; serum ferritin > or = 100 ng/ml or transferrin saturation > or = 15 % ) scheduled to receive chemotherapy and epoetin alfa ( 40,000 U subcutaneously weekly ) were r and omized to 8 weeks of 125 mg of IV FG weekly , 325 mg of oral ferrous sulfate three times daily , or no iron . The primary outcome was a change in Hb from baseline to endpoint , first whole-blood or red blood cell transfusion , or study withdrawal . RESULTS One hundred twenty-nine patients were evaluable for efficacy ( FG , n = 41 ; oral iron , n = 44 ; no iron , n = 44 ) . Mean increase in Hb was 2.4 g/dl ( 95 % confidence interval [ CI ] , 2.1 - 2.7 ) for FG ( p = .0092 vs. oral iron ; p = .0044 vs. no iron ) , 1.6 g/dl ( 95 % CI , 1.1 - 2.1 ) for oral iron ( p = .7695 vs. no iron ) , and 1.5 g/dl ( 95 % CI , 1.1 - 1.9 ) for no iron . Hb response ( increase > or = 2 g/dl ) was 73 % for FG ( p = .0099 vs. oral iron ; p = .0029 vs. no iron ) , 46 % for oral iron ( p = .6687 vs. no iron ) , and 41 % for no iron . FG was well tolerated . CONCLUSION For cancer patients with chemotherapy-related anemia receiving epoetin alfa , FG produces a significantly greater increase in Hb and Hb response compared with oral iron or no iron , supporting more aggressive treatment with IV iron supplementation for these patients Iron deficiency anemia ( IDA ) is the most common form of anemia worldwide . Although oral iron is used as first‐line treatment , many patients are unresponsive to or can not take oral iron . This Phase III , open‐label , non‐inferiority study compared the efficacy and safety of ferumoxytol , a rapid , injectable intravenous ( IV ) iron product with low immunological reactivity and minimal detectable free iron , with IV iron sucrose in adults with IDA of any cause . Patients ( N = 605 ) were r and omized 2:1 to receive ferumoxytol ( n = 406 , two doses of 510 mg 5 ± 3 days apart ) or iron sucrose ( n = 199 , five doses of 200 mg on five nonconsecutive days over 14 days ) and followed for 5 weeks . Ferumoxytol demonstrated noninferiority to iron sucrose at the primary endpoint , the proportion of patients achieving a hemoglobin increase of ≥2 g dL−1 at any time from Baseline to Week 5 ( ferumoxytol , 84.0 % [ n = 406 ] vs. iron sucrose , 81.4 % [ n = 199 ] ) , with a noninferiority margin of 15 % . Ferumoxytol was superior to iron sucrose ( 2.7 g dL−1 vs. 2.4 g dL−1 ) in the mean change in hemoglobin from Baseline to Week 5 ( the alternative preplanned primary endpoint ) with P = 0.0124 . Transferrin saturation , quality ‐of‐life measures , and safety outcomes were similar between the two treatment groups . Overall , ferumoxytol  demonstrated comparable safety and efficacy to iron sucrose , suggesting that ferumoxytol may be a useful treatment option for patients with IDA in whom oral iron was unsatisfactory or could not be used . Am . J. Hematol . 89:646–650 , 2014 . © 2014 Wiley Periodicals , BACKGROUND Iron deficiency may impair aerobic performance . This study aim ed to determine whether treatment with intravenous iron ( ferric carboxymaltose ) would improve symptoms in patients who had heart failure , reduced left ventricular ejection fraction , and iron deficiency , either with or without anemia . METHODS We enrolled 459 patients with chronic heart failure of New York Heart Association ( NYHA ) functional class II or III , a left ventricular ejection fraction of 40 % or less ( for patients with NYHA class II ) or 45 % or less ( for NYHA class III ) , iron deficiency ( ferritin level < 100 microg per liter or between 100 and 299 microg per liter , if the transferrin saturation was < 20 % ) , and a hemoglobin level of 95 to 135 g per liter . Patients were r and omly assigned , in a 2:1 ratio , to receive 200 mg of intravenous iron ( ferric carboxymaltose ) or saline ( placebo ) . The primary end points were the self-reported Patient Global Assessment and NYHA functional class , both at week 24 . Secondary end points included the distance walked in 6 minutes and the health-related quality of life . RESULTS Among the patients receiving ferric carboxymaltose , 50 % reported being much or moderately improved , as compared with 28 % of patients receiving placebo , according to the Patient Global Assessment ( odds ratio for improvement , 2.51 ; 95 % confidence interval [ CI ] , 1.75 to 3.61 ) . Among the patients assigned to ferric carboxymaltose , 47 % had an NYHA functional class I or II at week 24 , as compared with 30 % of patients assigned to placebo ( odds ratio for improvement by one class , 2.40 ; 95 % CI , 1.55 to 3.71 ) . Results were similar in patients with anemia and those without anemia . Significant improvements were seen with ferric carboxymaltose in the distance on the 
    Output:
    
There were no statistically significant differences in mortality between iron and inactive control .
In all comparisons , there were no differences in the results comparing patients with and without heart failure .
Both oral and parenteral iron are shown to decrease the proportion of people who require blood transfusion and increase haemoglobin levels , without any benefit on mortality .