Impact of epoetin β on quality of life in patients with malignant disease

Abstract

This open-label, prospective study was conducted to compare the impact of epoetin b vs standard care on quality of life (QoL) in anaemic patients with lymphoid or solid tumour malignancies. A total of 262 anaemic patients (haemoglobin [Hb]p11 g dl À1 ) were randomised to a 12-week treatment with s.c. epoetin b (initial dose 150 IU kg À1 three times weekly) or standard care. Transfusions were recommended for both groups at an Hb threshold of 8.5 g dl À1 . The primary efficacy variables were improvement in QoL as measured using the Short-Form-36 physical component summary (SF-36 PCS) score and the Functional Assessment of Cancer Therapy fatigue and anaemia subscales (FACT-F and FACT-An). A visual analogue scale (VAS) was also used as a global QoL measure. Clinical response was defined as a X2 g dl À1 increase in Hb level without need of transfusion after the initial 4 weeks of treatment. Baseline to final visit changes in SF-36 PCS, FACT-F and VAS scores were significantly greater with epoetin b than with standard care (Po0.05); changes in FACT-An subscale score tended to be greater with epoetin b (P ¼ 0.076). Epoetin b significantly increased Hb concentrations relative to standard care (responders: 47% vs 13%; Po0.001). Levels of endogenous erythropoietin o50 mIU ml À1 were significantly predictive of response (OR 2.496, 95% CI: 1.21 -5.13). Epoetin b therapy significantly improves QoL compared with standard care in anaemic patients with solid tumours and lymphoid malignancies.

Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis

“…The pooled risk of these outcomes did not differ significantly between groups (RR for cardiovascular events 1.12, 95% CI 0.83 to 1.50, I 2 = 0%; RR for hypertension 1.41, 95% CI 0.94 to 2.12, I 2 = 0%). Health-related quality of life One otherwise eligible trial reported changes in generic measures of overall quality of life; 37 however, we excluded it because it was the only study that reported these outcomes.…”

Effect of treatment with epoetin beta on short-term tumour progression and survival in anaemic patients with cancer: a meta-analysis

“…Erythropoietic agents have been shown to increase haemoglobin (Hb) levels and reduce transfusion requirements in patients with cancer (Littlewood et al, 2001;Ö sterborg et al, 2002;Vansteenkiste et al, 2002;Boogaerts et al, 2003;Bohlius et al, 2004). Treatment with epoetin also alleviates fatigue and other symptoms of anaemia and produces significant improvements in QoL compared with placebo or standard transfusion therapy (Ö sterborg et al, 2002;Boogaerts et al, 2003).…”

Treatment Options for Anemia, Taking Risks into Consideration: Erythropoiesis-Stimulating Agents Versus Transfusions

“…A meta-analysis of data from 15 randomized controlled trials of epoetin showed a consistently high rate of hematologic response, with an overall risk ratio of 3.42 (95% confidence interval [CI], 3.03-3.06) relative to control (Table 1) [13,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The likelihood of Hb response is at least as large when the starting Hb level is 10-12 g/dl as it is when baseline Hb is <10 g/dl.…”