Anemia - Highlights

Highlights

Erythropoiesis-Stimulating Drugs

In 2006, the Food and Drug Administration (FDA) issued an advisory regarding treatment targets for erythropoiesis-stimulating drugs. These drugs include epoetin alfa (Procrit, Epogen, and Eprex) and darbepoetin alfa (Aranesp). They are used to treat severe anemia caused by other diseases, such as chronic kidney disease.

Two 2006 studies in the New England Journal of Medicine indicated that aggressive dosing to completely normalize anemia (hemoglobin levels of 13.5 g/dL) provided no greater benefit than lower dosing to partially correct anemia (hemoglobin levels of 10 – 12 g/dL). Higher dosing and higher hemoglobin levels increased the risk for heart failure, heart attack, and stroke.

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In response to these studies, the FDA recommends that patients who take these drugs should:·

• Maintain hemoglobin levels that do not exceed 12 g/dL.
• Receive frequent blood tests to monitor hemoglobin levels.
• Contact their doctors if they experience such symptoms as shortness of breath, pain, swelling in the legs, or increases in blood pressure.

Anemia in the Elderly

Mild anemia may cause difficulties with problem-solving abilities and other cognitive functions, suggests a 2006 study in the Journal of the American Geriatrics Society.

Diagnosing Fetal Anemia

Doppler ultrasonography may be better and safer than amniocentesis for diagnosing fetal anemia, according to a 2006 study in the New England Journal of Medicine. Doppler ultrasonography is a non-invasive imaging test.

Investigational Drugs

Eculizumab, an investigational monoclonal antibody drug, may help improve anemia in patients with paroxysmal nocturnal hemoglobinuria (PNH), indicates a 2006 study in the New England Journal of Medicine. PNH is a rare and severe form of hemolytic anemia. There are few treatment options for this condition.

Review Date: 01/17/2007
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital