A quick scoping review of efficacy, safety, economic, and health-related quality-of-life outcomes of short- and long-acting erythropoiesis-stimulating agents in the treatment of chemotherapy-induced anemia and chronic kidney disease anemia

Abstract

Erythropoiesis-stimulating agents (ESAs) are man-made forms of erythropoietin used in the treatment of anemia. This quick-scoping review of systematic literature reviews (SLRs) was conducted to define the clinical, economic, and health-related quality of life (HRQoL) outcomes for short-acting and long-acting ESAs in patients with chronic kidney disease-induced anemia (CKD-IA) and patients with chemotherapy-induced anemia (CIA). Embase, Medline, and the Cochrane Database of Systematic Reviews were searched from their establishment until October 2017. SLRs related to the use of short-acting and long-acting ESAs in the treatment of CIA and CKD-IA were included. Forty-eight studies met the inclusion criteria. The evidence suggests little difference in efficacy, HRQoL, and safety outcomes among ESA types. Cost-effectiveness and market price are likely to become determining factors driving the choice of agent. Comparative studies and costing models accounting for the utilization of biosimilars are needed to establish which ESAs are more cost-effective.

Direct healthcare costs of chronic kidney disease management in Italy: What cost‐savings can be achieved with higher biosimilar uptake and more appropriate use of erythropoiesis‐stimulating agents?

“…A recent review on the comparative efficacy, safety, economic, and health-related quality-of-life outcomes of short-and long-acting ESAs in the treatment of chemotherapyinduced anemia and chronic kidney disease anemia showed that systematic literature reviews comparing short-acting and long-acting ESAs found conflicting results or little differences in their cost-effectiveness. 34 Indeed, some systematic literature reviews suggested a cost advantage for epoetin alfa relative to darbepoetin alfa, 35,36 others reported that there was no evidence of any relevant cost differences 37 or alluded that drug-cost savings could be achieved with darbepoetin alfa. 38,39 Another major finding of this study was that increasing biosimilar use is not the only way to reduce costs among ESA users.…”

Associations of Hemoglobin Levels With Health-Related Quality of Life, Physical Activity, and Clinical Outcomes in Persons With Stage 3-5 Nondialysis CKD

“…Findings of prior observational studies of stage 3-5 ND-CKD patients have varied from reporting no or weak associations between Hgb levels and various HRQOL domains, 26 to reporting strong associations between Hgb levels with some of the same HRQOL domains observed in this study. 6,10,[27][28][29][30][31][32] Very limited information exists regarding the connection between anemia and physical functioning in ND-CKD patients. 7,8,33 In response, we collected data on patientreported physical activity levels via the RAPA instrument.…”

Effect of Subcutaneous Recombinant Human Erythropoietin on Blood Pressure in Pre-Dialysis Chronic Kidney Disease (Ckd) Patients

“…Studies have shown that the SC dose of erythropoietin required to achieve a target Hb level is approximately 30 percent less than that required with IV administration 17 . Some adverse effects have also been reported when ESAs are used to attain a normal hemoglobin level [18][19] . Hypertension is one of the most common side effect of ESA therapy [20][21] .…”