Prevalence and treatment of anemia with once-weekly epoetin alfa in patients with diabetes and chronic kidney disease.
OBJECTIVE
To describe the characteristics and prevalence of anemia in patients with diabetes and chronic kidney disease (CKD) not receiving dialysis and to evaluate the efficacy and safety of once-weekly (QW) epoetin alfa for the treatment of anemia in these patients.


METHODS
Post hoc subset analyses were conducted for 2 studies: a prospective, multicenter survey evaluating the prevalence of anemia in patients with CKD (the Prevalence of Anemia in Early Renal Insufficiency [PAERI] study) and a prospective, multicenter, open-label trial evaluating the efficacy and safety of QW epoetin alfa for the treatment of anemia associated with CKD (the Clinical Evaluation of Procrit Dosed Once Weekly in Patients With Anemia Due to Early Renal Insufficiency [POWER] study). Patients in the POWER study received epoetin alfa, 10,000 U subcutaneously QW for up to 16 weeks. Each study subset consisted of patients with type 1 or type 2 diabetes.


RESULTS
More than 60% of patients in both studies had diabetes. In the PAERI study, 52.4% of the patients with diabetes (N = 3,361) had a hemoglobin (Hb) level < or = 12 g/dL, and 10.5% had Hb < or = 10 g/dL. Female sex, African American race, reduced kidney function, reduced transferrin saturation, and diabetes as the cause of CKD were strongly associated with anemia. In the POWER study, the mean Hb level in the patients with diabetes (N = 816) increased from 9.1 g/dL (baseline) to 11.6 g/dL (final); the mean increase in Hb from baseline was 2.4 g/dL (P<0.0001). Epoetin alfa therapy was associated with significant quality of life improvements and was well tolerated.


CONCLUSIONS
Diabetes is prevalent in patients with CKD not receiving dialysis, and anemia is prevalent among these patients. Epoetin alfa QW is safe and effective in treating anemia in these patients.
Lorber
Daniel L
DL
Division of Endocrinology, New York Hospital Queens, Flushing, New York 11365, USA.
Provenzano
Robert
R
McClellan
William
W
D000368:Aged; D000740:Anemia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000188:drug therapy* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000150:complications; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D005919:Glomerular Filtration Rate; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D011994:Recombinant Proteins; D014168:Transferrin / Q000378:metabolism
D006454:Hemoglobins; D011994:Recombinant Proteins; D014168:Transferrin; D004921:Erythropoietin; D000068817:Epoetin Alfa; D005293:Ferritins; D003404:Creatinine