Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis
Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis. Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and i...
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| Veröffentlicht in: | Kidney international 2004-03, Vol.65 (3), p.757-767 |
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| creator | Jones, Michael Ibels, Lloyd Schenkel, Brad Zagari, Martin |
| description | Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis.
Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and improves quality of life in anemic patients with chronic renal failure. However, this accumulation of data has yet to be systematically examined. The objectives of this meta-analysis were to quantify the effects of epoetin alfa on clinical efficacy, quality of life, hospitalizations, and transfusions by collecting and analyzing the published body of evidence.
Sixteen published studies fulfilled all inclusion criteria and were subjected to data extraction. Data specifically related to hemoglobin and/or hematocrit levels, quality-of-life measurements, number and length of hospitalizations, and number of blood transfusions were then pooled across studies using a random effects meta-analysis. Simple combined estimates of the preselected variables were calculated, and adjusted estimates were made using meta-regression.
Baseline hemoglobin levels (11g/dL) for the pooled study group. Substantial improvements (10% to 70%) were observed for all measures of quality of life. In addition, patients who received epoetin alfa had substantial reductions in hospitalization rate, hospital length of stay, transfusion rate, and number of units transfused.
This meta-analysis strongly suggests that epoetin alfa therapy for patients with chronic renal failure provides important clinical and quality-of-life benefits while substantially reducing hospitalizations and transfusions. |
| doi_str_mv | 10.1111/j.1523-1755.2004.00450.x |
| format | Article |
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Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and improves quality of life in anemic patients with chronic renal failure. However, this accumulation of data has yet to be systematically examined. The objectives of this meta-analysis were to quantify the effects of epoetin alfa on clinical efficacy, quality of life, hospitalizations, and transfusions by collecting and analyzing the published body of evidence.
Sixteen published studies fulfilled all inclusion criteria and were subjected to data extraction. Data specifically related to hemoglobin and/or hematocrit levels, quality-of-life measurements, number and length of hospitalizations, and number of blood transfusions were then pooled across studies using a random effects meta-analysis. Simple combined estimates of the preselected variables were calculated, and adjusted estimates were made using meta-regression.
Baseline hemoglobin levels (<8g/dL) increased substantially (40% to 50%) after epoetin alfa administration to a nonanemic state (Hb >11g/dL) for the pooled study group. Substantial improvements (10% to 70%) were observed for all measures of quality of life. In addition, patients who received epoetin alfa had substantial reductions in hospitalization rate, hospital length of stay, transfusion rate, and number of units transfused.
This meta-analysis strongly suggests that epoetin alfa therapy for patients with chronic renal failure provides important clinical and quality-of-life benefits while substantially reducing hospitalizations and transfusions.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1111/j.1523-1755.2004.00450.x</identifier><identifier>PMID: 14871396</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>anemia ; Anemia - drug therapy ; Anemia - etiology ; Biological and medical sciences ; chronic renal failure ; Epoetin Alfa ; Erythropoietin - therapeutic use ; Hematinics - therapeutic use ; hospitalization ; Humans ; Kidney Failure, Chronic - complications ; Medical sciences ; meta-analysis ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; quality of life ; Recombinant Proteins ; Renal failure ; transfusion</subject><ispartof>Kidney international, 2004-03, Vol.65 (3), p.757-767</ispartof><rights>2004 International Society of Nephrology</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Mar 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-4140cd8b9229a056fc9279fe2107db068ba32ab0f492ab9f92ac5d4c116840083</citedby><cites>FETCH-LOGICAL-c477t-4140cd8b9229a056fc9279fe2107db068ba32ab0f492ab9f92ac5d4c116840083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15643506$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14871396$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jones, Michael</creatorcontrib><creatorcontrib>Ibels, Lloyd</creatorcontrib><creatorcontrib>Schenkel, Brad</creatorcontrib><creatorcontrib>Zagari, Martin</creatorcontrib><title>Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis.
Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and improves quality of life in anemic patients with chronic renal failure. However, this accumulation of data has yet to be systematically examined. The objectives of this meta-analysis were to quantify the effects of epoetin alfa on clinical efficacy, quality of life, hospitalizations, and transfusions by collecting and analyzing the published body of evidence.
Sixteen published studies fulfilled all inclusion criteria and were subjected to data extraction. Data specifically related to hemoglobin and/or hematocrit levels, quality-of-life measurements, number and length of hospitalizations, and number of blood transfusions were then pooled across studies using a random effects meta-analysis. Simple combined estimates of the preselected variables were calculated, and adjusted estimates were made using meta-regression.
Baseline hemoglobin levels (<8g/dL) increased substantially (40% to 50%) after epoetin alfa administration to a nonanemic state (Hb >11g/dL) for the pooled study group. Substantial improvements (10% to 70%) were observed for all measures of quality of life. In addition, patients who received epoetin alfa had substantial reductions in hospitalization rate, hospital length of stay, transfusion rate, and number of units transfused.
This meta-analysis strongly suggests that epoetin alfa therapy for patients with chronic renal failure provides important clinical and quality-of-life benefits while substantially reducing hospitalizations and transfusions.</description><subject>anemia</subject><subject>Anemia - drug therapy</subject><subject>Anemia - etiology</subject><subject>Biological and medical sciences</subject><subject>chronic renal failure</subject><subject>Epoetin Alfa</subject><subject>Erythropoietin - therapeutic use</subject><subject>Hematinics - therapeutic use</subject><subject>hospitalization</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Medical sciences</subject><subject>meta-analysis</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>quality of life</subject><subject>Recombinant Proteins</subject><subject>Renal failure</subject><subject>transfusion</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkVFv1SAUx4nRuOv0Kxhiom_toIW2-DYXp0uW-LI9E0oPGTdtqUDd9u093b1xiS8jgQOc3zkc_ocQylnJcZztSy6ruuCtlGXFmChxSlY-vCK7f47XZMdYJ4tK1t0JeZfSnuFZ1ewtOeGia3mtmh2Bq2kxNtPgKCwBsp-pGZ2hYaZ29LO3ZqQwD3QJfs6Jonsx2cO2v_f5jtq7GJCiEWYknfHjGuErPacTZFMYvHxMPr0nb5wZE3w42lNye_n95uJncf3rx9XF-XVhRdvmQnDB7ND1qqqUYbJxVlWtclBx1g49a7re1JXpmRMKjXK4WjkIy3nTCfxcfUq-HPIuMfxeIWU9-WRhHM0MYU26Y_jzRnEEP_0H7sMasdqk8TGOdcgGoe4A2RhSiuD0Ev1k4qPmTG990Hu9ya03ufXWB_3UB_2AoR-P-dd-guE58Cg8Ap-PgEmosYtmtj49c7IRtWQb9-3AAcr2x0PUyaL8FgYfwWY9BP9yNX8BEIqlXA</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Jones, Michael</creator><creator>Ibels, Lloyd</creator><creator>Schenkel, Brad</creator><creator>Zagari, Martin</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis</title><author>Jones, Michael ; Ibels, Lloyd ; Schenkel, Brad ; Zagari, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-4140cd8b9229a056fc9279fe2107db068ba32ab0f492ab9f92ac5d4c116840083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>anemia</topic><topic>Anemia - drug therapy</topic><topic>Anemia - etiology</topic><topic>Biological and medical sciences</topic><topic>chronic renal failure</topic><topic>Epoetin Alfa</topic><topic>Erythropoietin - therapeutic use</topic><topic>Hematinics - therapeutic use</topic><topic>hospitalization</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Medical sciences</topic><topic>meta-analysis</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>quality of life</topic><topic>Recombinant Proteins</topic><topic>Renal failure</topic><topic>transfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jones, Michael</creatorcontrib><creatorcontrib>Ibels, Lloyd</creatorcontrib><creatorcontrib>Schenkel, Brad</creatorcontrib><creatorcontrib>Zagari, Martin</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jones, Michael</au><au>Ibels, Lloyd</au><au>Schenkel, Brad</au><au>Zagari, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>65</volume><issue>3</issue><spage>757</spage><epage>767</epage><pages>757-767</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis.
Numerous randomized, controlled trials have demonstrated that recombinant human erythropoietin (rHuEPO, epoetin alfa) significantly raises hemoglobin levels, reduces transfusion requirements, and improves quality of life in anemic patients with chronic renal failure. However, this accumulation of data has yet to be systematically examined. The objectives of this meta-analysis were to quantify the effects of epoetin alfa on clinical efficacy, quality of life, hospitalizations, and transfusions by collecting and analyzing the published body of evidence.
Sixteen published studies fulfilled all inclusion criteria and were subjected to data extraction. Data specifically related to hemoglobin and/or hematocrit levels, quality-of-life measurements, number and length of hospitalizations, and number of blood transfusions were then pooled across studies using a random effects meta-analysis. Simple combined estimates of the preselected variables were calculated, and adjusted estimates were made using meta-regression.
Baseline hemoglobin levels (<8g/dL) increased substantially (40% to 50%) after epoetin alfa administration to a nonanemic state (Hb >11g/dL) for the pooled study group. Substantial improvements (10% to 70%) were observed for all measures of quality of life. In addition, patients who received epoetin alfa had substantial reductions in hospitalization rate, hospital length of stay, transfusion rate, and number of units transfused.
This meta-analysis strongly suggests that epoetin alfa therapy for patients with chronic renal failure provides important clinical and quality-of-life benefits while substantially reducing hospitalizations and transfusions.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>14871396</pmid><doi>10.1111/j.1523-1755.2004.00450.x</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Kidney international, 2004-03, Vol.65 (3), p.757-767 |
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| subjects | anemia Anemia - drug therapy Anemia - etiology Biological and medical sciences chronic renal failure Epoetin Alfa Erythropoietin - therapeutic use Hematinics - therapeutic use hospitalization Humans Kidney Failure, Chronic - complications Medical sciences meta-analysis Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure quality of life Recombinant Proteins Renal failure transfusion |
| title | Impact of epoetin alfa on clinical end points in patients with chronic renal failure: A meta-analysis |
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