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my personal edition > anaemia > news
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DGDispatch
Erythropoiesis Stimulating Agents Have Positive Cardiovascular Effects in Patients With Heart Failure, Anaemia: Presented at HFSA
BOSTON -- September 19, 2009 -- Patients with heart failure and anaemia who are treated with erythropoiesis stimulating agents (ESA) benefit in 6 cardiovascular parameters, compared with placebo, according to a meta-analysis reported here at the 13th Annual Scientific Meeting of the Heart Failure Society of America (HFSA).
"Overall, we found substantial improvement in clinical markers in heart function by administering EPO [erythropoietin]," said Faramarz Tehrani, MD, Department of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, at a poster presentation on September 14. "All of the signs in this meta-analysis point in the direction that EPO is actually beneficial with these patients."
Researchers examined the results of 7 prospective controlled studies to determine if ESA, including darbepoetin alfa, epoetin alfa, and epoetin beta, were effective in the treatment of patients with concomitant heart failure and anaemia. Patients were followed up for an average of 12 to 27 weeks.
Compared with placebo, at least 3 of the 7 trials show that ESA therapy was associated with improvement in 6 cardiovascular parameters. Researchers observed increases in haemoglobin levels of 2.35 (95% confidence interval [CI], 1.76-2.93; P < .00001) and in exercise duration 0.91 (95% CI, 0.08-1.73; P = .03).
They also saw a decrease in New York Heart Association functional class -1.46 (95% CI, -2.32 to -0.60; P = .0009) and in B-type natriuretic peptide -0.54 (95% CI, -1.03 to -0.06; P = .03). Improvements in peak oxygen consumption 0.93 (95% CI, 0.52-1.34; P < .00001) and in a 6-minute walk test 1.42 (95% CI, 0.31-2.54; P = .01) were also seen.
"Since this was a meta-analysis, we looked at past studies that didn't address some of the active issues of the day, such as concurrently administrating iron with this group of patients," said Dr. Tehrani. "Only 3 out of the 7 studies we analysed concurrently administered iron to patients, while now everyone would administer this to determine if iron or the administration of EPO improved the anaemia. This is an unfortunate limitation to the study."
Researchers concluded that large, prospective, randomised controlled trials are needed to further validate the potential effects of erythropoietin therapy in this patient population.
[Presentation title: Potential Benefit of Erythropoiesis Stimulating Agents in Heart Failure Patients With Anemia: A Meta-Analysis. Abstract 242]
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