Testing for iron deficiency; treating with oral iron; regimens of IV iron replacement (from provider and patient perspective); and ongoing clinical trials. The committee considered whether the potential benefits from iron replacement in people with iron-deficiency (with and without anaemia) was such that there should be a recommendation to test all people with HF for Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 iron-deficiency. There was consensus that iron studies were already done for everyone known to have anaemia (estimated at around 10% HF population), and that people with HF in a specialist clinic would generally also get iron studies, but that this left a large number who would currently not be tested. If any treatment recommendation were made, it would be important to raise awareness of iron-deficiency in HF amongst non-specialists in order to ensure equity of access to treatment. However, since this review has not looked at the effectiveness of testing for iron deficiency, the committee could only consider a recommendation that all people with HF be tested if there was robust evidence of both clinical and cost effectiveness of treating identified iron deficiency, particularly in those without anaemia. Since this was lacking, the committee felt that no such recommendations could be made, but felt that this could change in the future. It was discussed that despite general consensus that oral iron was largely ineffective and poorly tolerated, patients were sometimes offered oral iron in clinical practice, often by their GP. This clinical opinion was confirmed by the results from the IRONOUT-HF study which showed that oral iron did not have a clinical benefit in people with HFREF and iron deficiency. The committee considered the different regimens of IV iron in various trials and in the real-life situation. 