Scientific Poster Session III - Original Research

Abstract

Erythropoiesis-stimulating agents (ESAs) are part of guideline-directed management of anemia in chronic kidney disease. Documented benefits of ESAs therapy include improved quality of life, physical function, and reduction in packed red blood cell (PRBC) transfusions. Despite ESAs being commonly prescribed, there is a lack of literature regarding optimal dosing in acutely hospitalized patients.

Research Question or Hypothesis:

What is the efficacy and safety of different epoetin alfa-epbx (EPO) dosing strategies among acutely ill hospitalized patients?

Study Design:

Single-center, retrospective chart review.

Methods:

Patients were included if they had hospital length of stay (LOS) = 3 days, were diagnosed with anemia, and received = 2 doses of EPO. Patients were categorized according to EPO dose: group 1 (= 100 units/kilogram/dose), group 2 (101-200 units/kilogram/dose), and group 3 (= 201 units/kilogram/dose). The primary efficacy outcome was an absolute change in hemoglobin (Hb). Chi-Square and Kruskal-Wallis tests were used for categorical and continuous variables, respectively. Statistical significance was considered at a p-value of <0.05. All analyses were performed using SPSS.

Results:

A total of 734 eligible patients were included. The primary efficacy outcome of absolute median change in Hb was 0.03 g/dL, 0 g/dL, and 0.20 g/dL (p=0.0016) for groups 1, 2, and 3, respectively. There were differences in relative median change in the last known Hb (p=0.002), absolute median change in the last known Hb (p=0.002), proportion of patients requiring PRBC transfusions (p=0.003), and median dose of EPO expressed in units/kilogram (p<0.001). However, there were no differences in the secondary safety endpoints of composite new onset of thrombotic and vascular events (p=0.665) and length of stay (p=0.957).

Conclusion:

In this study of anemic hospitalized patients, a higher EPO dosing strategy compared to a lower one resulted in statistically significant, albeit clinically minor increases in Hb levels, with no benefit on the rate of PRBC transfusions.

Presenting Author

Authors