DALLAS Dec. 29, 2010 Patients with diabetes, kidney disease and anemia who don't respond to treatment with an anti-anemia drug have a higher risk of cardiovascular disease or death, researchers at UT Southwestern Medical Center have found.
The results suggest that testing such patients' responsiveness to the drug and keeping blood iron levels a little low might reduce their risk, said Dr. Robert Toto, professor of internal medicine and clinical sciences and a senior author of the study, which appeared in the New England Journal of Medicine.
"These patients required higher doses and ended up having lower hemoglobin anyway," Dr. Toto said. "The results of this study might lead us in directions that can help."
The results were an unexpected finding of a study on darbepoetin alpha, which stimulates the production of red blood cells to counteract anemia. The drug, manufactured by Amgen, is sold under the name Aranesp.
The study, called the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT) showed that darbepoetin alpha works no better than a placebo for improving cardiovascular and kidney outcomes, but it did lower the risk for blood transfusion and resulted in modest improvement in patient-reported outcomes among people with diabetes, kidney disease and anemia. However, people receiving darbepoetin alpha had nearly a twofold higher risk for stroke. Cancer deaths were also higher among people receiving the drug.
Darbepoetin alpha is one of a class of anti-anemia drugs that mimics erythropoietin, the body's natural hormone that stimulates production of red blood cells.
The combination of type 2 diabetes, chronic kidney disease and anemia affect about 1 million people in the U.S.
TREAT was a double-blinded experiment with a control group that received a placebo. It included 4,038 participants, all of whom had type 2 diabetes, anemia and kidney damage, although not enough to re
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UT Southwestern Medical Center