He reported that using a dosage regimen similar to CONFIRM-HF was generally well tolerated. It was suggested, however, that the population currently given IV iron, like the population included in the clinical trials, may not be reflective of the population treated for HF in practice, and that tolerability may be worse in typical patients with HF who are on average older and have more comorbidities. No evidence was found indicating whether repeat administration will always be necessary, nor the frequency of any such repeat administration. However, the co-optee confirmed that the experience from the chronic kidney disease (CKD) community is that they actively recall patients to repeat iron infusion, as reflected in the CKD and anaemia guidelines, and there is no expectation that patients would stop needing iron supplementation. It was felt this was also likely to be the case for people with HF and iron deficiency. Oral iron Oral iron for people with HFREF and iron deficiency appeared to show a clinically important increase in mortality. In terms of adverse events, there was no evidence of a clinically important effect. Oral iron appeared to show a clinically important improvement in NYHA class, which may be suggestive Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 of an overall improvement in the severity of CHF symptoms in these patients. However, the width of the confidence intervals reduced the committee s ability to interpret this result. Oral iron showed a marginal increase in peak VO2 max and a relative decrease in distance walked in the 6-minute walk test. However, these results were reported as median and interquartile range and therefore could not be assessed for imprecision. 