A popular drug treatment for anemia and chronic kidney disease may cause more harm than good, according to a new study published by WesternU College of Pharmacy Professor Cynthia Jackevicius in the Journal of Cardiac Failure.

The study, “Clinical Outcomes of Erythropoietin Use in Heart Failure Patients with Anemia of Chronic Kidney Disease,” by Cynthia Jackevicius, BScPhm, PharmD, MSc, BCPS, Cindy Shutieng Fan, PharmD, and Alberta Warner, MD, assesses clinical outcomes associated with erythropoietin (EPO) treatment in the cardio-renal-anemia syndrome (CRAS) population. Heart failure (HF), chronic kidney disease (CKD) and anemia often occur concurrently, and are coined the CRAS. Individuals with all three factors are at particularly high risk for adverse cardiovascular events.

The authors conducted a retrospective cohort study using administrative and clinical data from Veterans Affairs Greater Los Angeles Healthcare system. Veterans Affairs Greater Los Angeles patients from Jan. 1, 2003 to Dec. 31, 2006 were included.

EPO use was associated with increased risk of mortality and a trend toward increased cardiovascular events in CRAS patients. Therefore, clinicians considering EPO use in CRAS patients should assess whether any potential benefits outweigh the risks of use.

“This study suggests caution in the use of EPO in patients with the combination of heart failure, chronic kidney disease and anemia,” Jackevicius said. “Our study adds to prior research that similarly found increased risk of death and/or cardiovascular events with the use of EPO in patients of anemia and chronic kidney disease. While EPO may improve patient’s blood counts for anemia, our study suggests this needs to be balanced against the potential harms of the medication that we found in this study.”

The complete citation is: Jackevicius C, Fan CS, Warner A, Clinical Outcomes of Erythropoietin Use in Heart Failure Patients with Anemia of Chronic Kidney Disease, Journal of Cardiac Failure (2014), doi: 10.1016/j.cardfail.2014.02.001.

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