title: BiOsimilaRs in the management of anaemia secondary to chemotherapy in HaEmatology and Oncology: results of the ORHEO observational study.
abstract: BACKGROUND
  The approval of epoetin biosimilars in the European Union requires extensive scientific evaluation and stringent regulatory procedures, including post-marketing studies. The ORHEO (place of biOsimilaRs in the therapeutic management of anaemia secondary to chemotherapy in HaEmatology and Oncology) study was an observational, longitudinal, multicentre study performed in France to evaluate the efficacy and safety of biosimilar epoetins for the treatment of chemotherapy-induced anaemia (CIA) in the clinical setting.
  
  
  METHODS
  Patients >18 years with CIA (haemoglobin [Hb] <11 g/dL) in association with solid tumours, lymphoma or myeloma and eligible for treatment with an epoetin biosimilar were included in this study. Patient characteristics were recorded at baseline along with anaemia-related information, such as observed and target Hb (as chosen by the treating clinician), brand and dose of epoetin biosimilar prescribed, and details of any other treatments. Patients were then followed-up at 3 and 6 months. The primary endpoint was Hb response (defined as Hb reaching ≥10 g/dL, an increase of Hb ≥1 g/dL since inclusion visit or reaching physician-defined target Hb, with no blood transfusions in the 3 weeks prior to measurement). Other endpoints included adverse events, achievement of target Hb and associated treatments.
  
  
  RESULTS
  Overall, 2333 patients >18 years (mean age 66.5 years) with CIA (haemoglobin [Hb] <11 g/dL) in association with solid tumours, lymphoma or myeloma and eligible for biosimilar epoetin treatment were included. 99.9% of patients received epoetin zeta (median dose 30,000 IU/week). Mean baseline Hb was 9.61 g/dL, with 35.6% of patients having moderate anaemia (Hb 8-9.5 g/dL). Hb response was achieved in 81.6% and 86.5% of patients at 3 and 6 months, respectively. Overall mean change in Hb level was 1.52 ± 1.61 and 1.72 ± 1.61 g/dL at 3 and 6 months, respectively. Transfusion and thromboembolic event rates were 9.4% and 2.4% at 3 months, and 5.8% and 1.5% at 6 months, respectively.
  
  
  CONCLUSIONS
  Epoetin zeta was effective and well tolerated in the management of CIA in patients with solid tumours, lymphoma and myeloma.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  NCT02140736 (date of registration: 14 May 2014).
authors.affiliation: Service d'Hématologie, Pavillon Marcel Bérard 1G, Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, Lyon- Pierre Bénite 69495, France. Mauricette.michallet@chu-lyon.fr.
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Luporsi
authors.forename: Pierre
authors.initials: P
authors.lastname: Soubeyran
authors.forename: Nadia Ali
authors.initials: NA
authors.lastname: Amar
authors.forename: Vincent
authors.initials: V
authors.lastname: Boulanger
authors.forename: Miguel
authors.initials: M
authors.lastname: Carreiro
authors.forename: Louis-Marie
authors.initials: LM
authors.lastname: Dourthe
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Labourey
authors.forename: Daniel
authors.initials: D
authors.lastname: Lepille
authors.forename: Frédéric
authors.initials: F
authors.lastname: Maloisel
authors.forename: Jean-Loup
authors.initials: JL
authors.lastname: Mouysset
authors.forename: Sophie
authors.initials: S
authors.lastname: Nahon
authors.forename: Bérengère
authors.initials: B
authors.lastname: Narciso
authors.forename: Pierre
authors.initials: P
authors.lastname: Nouyrigat
authors.forename: Raouf
authors.initials: R
authors.lastname: Radji
authors.forename: Nacéra
authors.initials: N
authors.lastname: Sakek
authors.forename: Hélène
authors.initials: H
authors.lastname: Albrand
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy; D059451:Biosimilar Pharmaceuticals / Q000008:administration & dosage / Q000009:adverse effects; D004921:Erythropoietin / Q000008:administration & dosage / Q000009:adverse effects; D005602:France; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D008137:Longitudinal Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D059451:Biosimilar Pharmaceuticals; C530192:epoetin zeta; D004921:Erythropoietin; D011994:Recombinant Proteins