Anemia Drugs and Kidney Patients' Well-Being
Review of 17 clinical trials finds no evidence that certain costly meds improve patients' quality of life
By Amy Norton
MONDAY, Feb. 15, 2016 (HealthDay News) -- The pricey anemia drugs often given to people with chronic kidney disease may make no difference in how they feel day to day, a new research review confirms.
Researchers said the study results back up current guidelines on how to use the drugs, called erythropoietin-stimulating agents (ESAs).
These include the injection drugs marketed under the names Procrit, Epogen and Aranesp.
Patients may still benefit from the medications because they reduce the need for blood transfusions to treat severe anemia, said Dr. Navdeep Tangri, senior researcher on the study.
"But this should close the book on the idea that these drugs help with exhaustion and improve patients' quality of life," said Tangri, an attending doctor at Seven Oaks General Hospital Renal Program in Manitoba, Canada.
However, one expert argued that while on average, that is true, some patients do feel better on the medications -- particularly younger, more active people.
People with chronic kidney disease often develop anemia, which hinders the blood's ability to transport oxygen. So doctors have long prescribed ESAs to boost blood levels of hemoglobin, the oxygen-carrying protein in red blood cells.
But in recent years, the drugs have come under closer scrutiny: Research has shown that using them to boost kidney patients' hemoglobin beyond a certain level -- around 11 grams per deciliter of blood -- can raise the risks of heart attack, stroke and blood clots.
So guidelines now recommend lower hemoglobin "targets," of no higher than 10 or 11. And the U.S. Food and Drug Administration says the only reason to prescribe the drugs to kidney disease patients is to curb the need for blood transfusions.
"They're not recommended for treating quality-of-life issues," said Dr. Jeffrey Berns, president of the National Kidney Foundation and a professor of medicine at the University of Pennsylvania.
Berns said the new study -- a review of 17 clinical trials -- "reinforces what's already out there." The new results were reported online Feb. 15 in the Annals of Internal Medicine.
In Berns' view, it makes sense that these medications would not change day-to-day life for many people with chronic kidney disease, especially those on dialysis. Patients are often older, have heart disease or other medical conditions, and are mostly sedentary.