SanteChoraleV4, Main, Exploration, bibRecord, 000215

Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes.

Identifieur interne : 000215 ( Main/Exploration ); précédent : 000214; suivant : 000216

Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes.

Auteurs : Lynda A. Szczech [États-Unis] ; Huiman X. Barnhart ; Jula K. Inrig ; Donal N. Reddan ; Shelly Sapp ; Robert M. Califf ; Uptal D. Patel ; Ajay K. Singh

Source :

Kidney international [ 1523-1755 ] ; 2008.

RBID : pubmed:18596733

Descripteurs français

KwdFr :
- Adulte d'âge moyen (MeSH), Anémie (traitement médicamenteux), Femelle (MeSH), Humains (MeSH), Hémoglobines (analyse), Insuffisance rénale (traitement médicamenteux), Maladie chronique (MeSH), Maladies du rein (complications), Maladies du rein (mortalité), Maladies du rein (sang), Maladies du rein (traitement médicamenteux), Mâle (MeSH), Protéines recombinantes (MeSH), Relation dose-effet des médicaments (MeSH), Risque (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Époétine alfa (MeSH), Érythropoïétine (administration et posologie).
MESH :
- administration et posologie : Érythropoïétine.
- analyse : Hémoglobines.
- mortalité : Maladies du rein.
- sang : Maladies du rein.
- traitement médicamenteux : Anémie, Insuffisance rénale, Maladies du rein.
- Adulte d'âge moyen, Femelle, Humains, Maladie chronique, Mâle, Protéines recombinantes, Relation dose-effet des médicaments, Risque, Résultat thérapeutique, Sujet âgé, Époétine alfa.

English descriptors

KwdEn :
- Aged (MeSH), Anemia (drug therapy), Chronic Disease (MeSH), Dose-Response Relationship, Drug (MeSH), Epoetin Alfa (MeSH), Erythropoietin (administration & dosage), Female (MeSH), Hemoglobins (analysis), Humans (MeSH), Kidney Diseases (blood), Kidney Diseases (complications), Kidney Diseases (drug therapy), Kidney Diseases (mortality), Male (MeSH), Middle Aged (MeSH), Recombinant Proteins (MeSH), Renal Insufficiency (drug therapy), Risk (MeSH), Treatment Outcome (MeSH).
MESH :
- chemical , administration & dosage : Erythropoietin.
- chemical , analysis : Hemoglobins.
- chemical : Epoetin Alfa, Recombinant Proteins.
- blood : Kidney Diseases.
- complications : Kidney Diseases.
- drug therapy : Anemia, Kidney Diseases, Renal Insufficiency.
- mortality : Kidney Diseases.
- Aged, Chronic Disease, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Risk, Treatment Outcome.

Abstract

Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Renal Insufficiency trial to measure the potential for competing benefit and harm from achieved hemoglobin and epoetin dose trials. In the 4 month analysis, significantly more patients in the high-hemoglobin compared to the low-hemoglobin arm were unable to achieve target hemoglobin and required high-dose epoetin-alpha. In unadjusted analyses, the inability to achieve a target hemoglobin and high-dose epoetin-alpha were each significantly associated with increased risk of a primary endpoint (death, myocardial infarction, congestive heart failure or stroke). In adjusted models, high-dose epoetin-alpha was associated with a significant increased hazard of a primary endpoint but the risk associated with randomization to the high hemoglobin arm did not suggest a possible mediating effect of higher target via dose. Similar results were seen in the 9 month analysis. Our study demonstrates that patients achieving their target had better outcomes than those who did not; and among subjects who achieved their randomized target, no increased risk associated with the higher hemoglobin goal was detected. Prospective studies are needed to confirm this relationship and determine safe dosing algorithms for patients unable to achieve target hemoglobin.

DOI: 10.1038/ki.2008.295
PubMed: 18596733
PubMed Central: PMC2902279

Affiliations:

Links toward previous steps (curation, corpus...)

to stream Main, to step Corpus: 000216
to stream Main, to step Curation: 000213

Le document en format XML

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<term>Chronic Disease (MeSH)</term>
<term>Dose-Response Relationship, Drug (MeSH)</term>
<term>Epoetin Alfa (MeSH)</term>
<term>Erythropoietin (administration & dosage)</term>
<term>Female (MeSH)</term>
<term>Hemoglobins (analysis)</term>
<term>Humans (MeSH)</term>
<term>Kidney Diseases (blood)</term>
<term>Kidney Diseases (complications)</term>
<term>Kidney Diseases (drug therapy)</term>
<term>Kidney Diseases (mortality)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Recombinant Proteins (MeSH)</term>
<term>Renal Insufficiency (drug therapy)</term>
<term>Risk (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
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<term>Anémie (traitement médicamenteux)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hémoglobines (analyse)</term>
<term>Insuffisance rénale (traitement médicamenteux)</term>
<term>Maladie chronique (MeSH)</term>
<term>Maladies du rein (complications)</term>
<term>Maladies du rein (mortalité)</term>
<term>Maladies du rein (sang)</term>
<term>Maladies du rein (traitement médicamenteux)</term>
<term>Mâle (MeSH)</term>
<term>Protéines recombinantes (MeSH)</term>
<term>Relation dose-effet des médicaments (MeSH)</term>
<term>Risque (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Époétine alfa (MeSH)</term>
<term>Érythropoïétine (administration et posologie)</term>
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<term>Kidney Diseases</term>
<term>Renal Insufficiency</term>
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<term>Chronic Disease</term>
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<term>Humans</term>
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<term>Mâle</term>
<term>Protéines recombinantes</term>
<term>Relation dose-effet des médicaments</term>
<term>Risque</term>
<term>Résultat thérapeutique</term>
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<front><div type="abstract" xml:lang="en">Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Renal Insufficiency trial to measure the potential for competing benefit and harm from achieved hemoglobin and epoetin dose trials. In the 4 month analysis, significantly more patients in the high-hemoglobin compared to the low-hemoglobin arm were unable to achieve target hemoglobin and required high-dose epoetin-alpha. In unadjusted analyses, the inability to achieve a target hemoglobin and high-dose epoetin-alpha were each significantly associated with increased risk of a primary endpoint (death, myocardial infarction, congestive heart failure or stroke). In adjusted models, high-dose epoetin-alpha was associated with a significant increased hazard of a primary endpoint but the risk associated with randomization to the high hemoglobin arm did not suggest a possible mediating effect of higher target via dose. Similar results were seen in the 9 month analysis. Our study demonstrates that patients achieving their target had better outcomes than those who did not; and among subjects who achieved their randomized target, no increased risk associated with the higher hemoglobin goal was detected. Prospective studies are needed to confirm this relationship and determine safe dosing algorithms for patients unable to achieve target hemoglobin.</div>
</front>
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<Abstract><AbstractText>Trials of anemia correction in chronic kidney disease have found either no benefit or detrimental outcomes of higher targets. We did a secondary analysis of patients with chronic kidney disease enrolled in the Correction of Hemoglobin in the Outcomes in Renal Insufficiency trial to measure the potential for competing benefit and harm from achieved hemoglobin and epoetin dose trials. In the 4 month analysis, significantly more patients in the high-hemoglobin compared to the low-hemoglobin arm were unable to achieve target hemoglobin and required high-dose epoetin-alpha. In unadjusted analyses, the inability to achieve a target hemoglobin and high-dose epoetin-alpha were each significantly associated with increased risk of a primary endpoint (death, myocardial infarction, congestive heart failure or stroke). In adjusted models, high-dose epoetin-alpha was associated with a significant increased hazard of a primary endpoint but the risk associated with randomization to the high hemoglobin arm did not suggest a possible mediating effect of higher target via dose. Similar results were seen in the 9 month analysis. Our study demonstrates that patients achieving their target had better outcomes than those who did not; and among subjects who achieved their randomized target, no increased risk associated with the higher hemoglobin goal was detected. Prospective studies are needed to confirm this relationship and determine safe dosing algorithms for patients unable to achieve target hemoglobin.</AbstractText>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Szczech</LastName>
<ForeName>Lynda A</ForeName>
<Initials>LA</Initials>
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<Author ValidYN="Y"><LastName>Singh</LastName>
<ForeName>Ajay K</ForeName>
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Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes.

Secondary analysis of the CHOIR trial epoetin-alpha dose and achieved hemoglobin outcomes.

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