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2015 ; 17
(11
): 1201-7
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients
with diabetes and chronic kidney disease
#MMPMID26423928
Bello NA
; Lewis EF
; Desai AS
; Anand IS
; Krum H
; McMurray JJ
; Olson K
; Solomon SD
; Swedberg K
; van Veldhuisen DJ
; Young JB
; Pfeffer MA
Eur J Heart Fail
2015[Nov]; 17
(11
): 1201-7
PMID26423928
show ga
AIMS: The use of an erythropoesis-stimulating agent, darbepoetin alfa (DA), to
treat anaemia in patients with diabetes mellitus and chronic kidney disease was
associated with a heightened risk of stroke and neutral efficacy in the Trial to
Reduce Cardiovascular Events with Aranesp Therapy (TREAT), despite
epidemiological data suggesting the contrary. However, this association has not
been evaluated in another randomized, placebo-controlled trial. METHODS AND
RESULTS: Reduction of Events by Darbepoetin Alfa in Heart Failure (RED-HF) was a
randomized placebo-controlled trial of DA in 2278 patients with systolic heart
failure and anaemia, enrolled from 2006 to 2012 and followed for a median of 28
months. Within RED-HF, 816 patients had diabetes mellitus and chronic kidney
disease [estimated glomerular filtration rate (eGFR) 20-60 mL/min/1.73 m(2) ] and
met inclusion criteria for TREAT. TREAT-like RED-HF patient data were analysed
alone and combined at the patient level with the 4038 TREAT patients. In RED-HF,
the annualized event rate of stroke was 2.3 in patients on DA and 1.1 in patients
randomized to placebo (P = 0.051). Analysis of the combined group (n = 4854)
confirmed a nearly two-fold increase in stroke risk [hazard ratio (HR) 1.94, 95%
confidence interval (CI) 1.43-2.63] and an overall neutral effect on mortality
(HR 1.00, 95% CI 0.89-1.12) of raising haemoglobin with DA. CONCLUSION: The
placebo-controlled cohort of heart failure patients with anaemia, diabetes
mellitus, and chronic kidney disease from RED-HF provides confirmation of the
increased stroke risk associated with DA use identified in TREAT.