Simpler Anemia Treatment May Help Kidney Patients
FRIDAY Oct. 19, 2007 -- A new approach for treating anemia in patients with severe kidney disease could help improve patients' quality of life, according to a U.S. study.
Compared with conventional therapy, giving patients an anti-anemia drug as infrequently as once a month could simplify anemia management, concluded Dr. Nathan Levin, of the Renal Research Institute in New York, and colleagues.
The findings are published in the Oct. 20 issue of The Lancet.
Conventional therapy with epoetin (a synthetic form of human erythropoietin that promotes red blood cell production) requires frequent administrations (at least once weekly), changes of dose, and close monitoring of hemoglobin concentrations.
In this study involving patients on dialysis, the researchers compared the use of a long-acting erythropoieses-stimulating agent variant of epoetin (methoxy polyethylene glycol-epoetin beta) given intravenously at 2-week or 4-week intervals, with epoetin treatment one to three times per week.
All 673 patients in the study received conventional epoetin treatment for the first four weeks of the study. After that, one group of patients received methoxy polyethylene glycol-epoetin beta every two weeks, another group received methoxy polyethylene glycol-epoetin beta every four weeks, and the third group continued receiving conventional epoetin treatment.
After about 42 weeks, there were no statistically significant differences in hemoglobin concentrations between the three groups. Based on their findings, the researchers recommended that methoxy polyethylene glycol-epoetin beta be introduced as an option for simplified management of anemia in patients on dialysis.
However, the authors of an accompanying Comment article called for more research.
"Before we can concur on a precise clinical role for this molecule, we need to explore issues other than simply the non-inferiority with other epoetins to reach certain unvalidated surrogates. Different doses and molecular characteristics of epoetins may affect patient-level endpoints, independent of achieved hemoglobin. When these issues are examined, we might be truly confident that a newer molecule is non-inferior to existing ones," wrote Dr. Rowan Walker of the Royal Melbourne Hospital and Monash University Alfred Hospital in Melbourne, Australia, and Dr. Giovanni Strippoli, of the University of Sydney, Australia, and the Mario Negri Sud Consortium in Chieti, Italy.
The U.S. National Institute on Diabetes and Digestive and Kidney Diseases has more about anemia.
Posted: October 2007