Dialysis patients treated with Epoetin α show improved exercise tolerance and physical function: A new analysis of the Canadian Erythropoietin Study Group trial.
The risks/benefits of anemia treatment in dialysis patients have been redefined in the US Epoetin α label. This analysis was carried out to determine if increasing hemoglobin (Hb) levels improve exercise tolerance and physical function in anemic dialysis patients. This is a new analysis of the Canadian Erythropoietin Study Group trial, a double-blind, randomized, placebo-controlled trial in dialysis patients. Subjects were 18 to 75 years old, on hemodialysis for >3 months, and had a baseline Hb <9.0 g/dL. Patients with a history of diabetes mellitus, ischemic heart disease, or severe/uncontrolled hypertension were excluded. Patients were randomized to receive Epoetin α to a target Hb of 9.5 to 11.0 g/dL (n=40) or a target of 11.5 to 13.0 g/dL (n=38), or receive placebo (n=40). Results from patients in the Epoetin-α-treated arms were combined for this analysis. Hb level, exercise tolerance (Treadmill Stress Test and 6-Minute Walk Test) and patient-reported physical function measures (Physical Summary domain from the Kidney Disease Questionnaire, and 4 domains from the Sickness Impact Profile) were reported at baseline and months 2, 4, and 6. Differences in measures were statistically significant for exercise tolerance (Treadmill Stress, P=0.0001) and patient-reported physical function (Kidney Disease Questionnaire Physical, P=0.0001; Sickness Impact Profile Physical, P=0.0015) across all time points for Epoetin-α-treated patients compared with placebo. Improvements were seen at 2 months and were maintained through months 4 and 6. Dialysis patients receiving Epoetin α showed improved exercise tolerance and physical function. These findings should be considered as physicians weigh the risks and benefits of treatment.
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Norman
N
Muirhead
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Paul A
PA
Keown
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
David N
DN
Churchill
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Melanie
M
Poulin-Costello
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Sandeep
S
Gantotti
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Lei
L
Lei
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Matthew
M
Gitlin
London Health Sciences Centre, University Hospital, University of Western Ontario, London, Ontario, CanadaDepartments of Medicine and Immunology, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Canada Inc., Mississauga, Ontario, CanadaAmgen Inc., Thousand Oaks, California, USADaVita Inc., El Segundo, California, USA.
Tracy J
TJ
Mayne
D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D004311:Double-Blind Method; D000068817:Epoetin Alfa / Q000008:administration & dosage / Q000627:therapeutic use*; D004921:Erythropoietin / Q000008:administration & dosage*; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods*; D055815:Young Adult
D004921:Erythropoietin; D000068817:Epoetin Alfa