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Review: erythropoiesis-stimulating agents increase mortality and venous thromboembolism in cancer-associated anaemia

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C L Bennett

Dr C L Bennett, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; cbenne@northwestern.edu

QUESTION

In patients with cancer-associated anaemia, do erythropoiesis-stimulating agents (ESAs) increase mortality and venous thromboembolism (VTE)?

REVIEW SCOPE

Included studies evaluated ESAs (erythropoietin and darbepoetin) in patients with cancer and anaemia. Outcomes were mortality and VTE.

REVIEW METHODS

Medline and EMBASE/Excerpta Medica (Apr 2005 to Jan 2008); a previous Cochrane review* (studies published between 1985 and Apr 2005); websites of the US Food and Drug Administration (FDA) (Oncologic Drug Advisory Committee 2007 meeting) and ESA manufacturers; and reports by health authorities and at national conferences were searched for phase 3 trials. 54 trials met the selection criteria: 51 reported survival (n = 13 611); 38 reported VTE (n = 8172). 43 trials evaluated epoetin-α or β (n = 9033), and 11 evaluated darbepoetin (n = 4733). Duration of treatment ranged from 6 …

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