Safety concerns in anaemia management
The identification of erythropoietin represented a major milestone in anaemia management
- Clinical development of erythropoiesis stimulating agents (ESAs), usually together with iron supplementation, resulted in reduced blood transfusions, improved anaemia correction and delayed time to haemodialysis.
Despite good efficacy, concerns have grown over ESA safety.
- Trials such as TREAT, a large randomized double-blind, placebo-controlled study, have highlighted the need for caution to minimise the risk of stroke and developing cancer.1
Accumulating evidence also supports the use of iron in CKD patients and the European Best Practice Group supports correcting iron deficiency prior to administering ESAs.2
When designing a treatment strategy, physicians should consider individual patients’ needs and weigh up the expected benefit against safety concerns.
1. Parfrey PS. Curr Opin Nephrol Hypertens. 2011 Mar;20(2):177-81
2. Locatelli F et al. Nephrol Dial Transplant 2004;19(suppl 2):ii1–47