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Controversial Anemia Drug Doesn't Cut Need for Transfusions
Date:9/5/2007

But it may reduce mortality rates among trauma patients, study finds

WEDNESDAY, Sept. 5 (HealthDay News) -- A drug widely used to treat anemia does not reduce the need for blood transfusions among critically ill patients, but it may reduce mortality in trauma patients.

The drug, epoetin alfa (brand names Epogen and Procrit) has been under regulatory scrutiny because of potentially dangerous side effects.

"Unlike prior studies, this trial found that we didn't reduce blood transfusions, although it still increased hemoglobin levels," said study author Dr. Howard L. Corwin, a professor of medicine and anesthesiology at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. "What we did find, particularly in trauma patients, was a reduction in mortality."

And this mortality benefit was likely due to other mechanisms of action caused by the drug. Once these mechanisms are understood, a whole new range of uses for the drug might be possible, the study authors said.

Overall, however, the drug did not seem to show an overwhelming benefit. "It didn't decrease the need for transfusions, which was the primary endpoint. And, in the majority of patients, which would be medical and surgical non-trauma patients, it did not improve survival," said Dr. Christian Cable, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine.

The study findings are published in the Sept. 6 issue of the New England Journal of Medicine.

Critically ill patients often develop anemia -- a decrease in the number of healthy red blood cells -- and require blood transfusions. But transfusions involve considerable risks, including death.

"It turns out that for most of the reasons transfusions are given, other than active bleeding, there is little evidence that they actually help and there is good evidence that red-blood-cell transfusions are associated with worse clinical
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