A Randomised Comparison of Darbepoetin alfa with Epoetin for Chemotherapy Induced Anaemia in Nonhaematological Tumours

Authors

  • Aekaterini A. Kotsori
  • Costas G. Alexopoulos

DOI:

https://doi.org/10.2015/hc.v1i1.6

Keywords:

Supportive care, fatigue, transfusions, cancer

Abstract

BACKGROUND: Although once weekly (QW) Darbepoetin is nowadays used by many for chemotherapy induced anaemia, a head to head comparison with thrice weekly (TIW) Epoetin regimen has not been published so far. PATIENTS AND METHODS: We randomly compared weekly (QW) darbepoetin alfa with thrice weekly (TIW) Epoetin in 50 cancer patients with chemotherapy induced anaemia (Hb ???11gr%). In Group A, Epoetin was administered at 10.000 U TIW (20.000 U in non-responders after 4 weeks). In Group B, Darbepoetin alfa was administered at 150mcg QW (300 mcg as above). Evaluation, including QOL assessment using FACT-An scale, was performed on week 4 and 8. RESULTS: In group A, Hb increased from 9.81?±1.02 at baseline to 10.59?±1.38 at 4 weeks (p=0.007) and to 11,4?±1,99 at 8 weeks (p=0.001). It also increased between week 4 and 8 (p=0.011). In group B, Hb increased from 10,2?±0,87 at baseline to 10,8?±1,93 at 4 weeks (p=0.075) and to 11.57?±2.26 at 8 weeks (p=0.005) without significant increase between week 4 and 8 (p=0.08). In all 50 patients, Hb increased from 10.01?±0.97 at baseline to 10.75?±1.69 at 4 weeks (p=0.003) and to 11.49?±2.11 at 8 weeks (p=0.000). It also increased from 10.84?±1.74 to 11.49?±2.11 (p=0.003) between week 4 and 8. Twelve of 25 patients (48%) in group A had to double the Epoetin dose versus 13 (52%) in group B (P=NS). Three patients in group A required transfusions compared with 4 in group B (p=NS). On an intent-to-treat analysis: RR, at 4 weeks, was 44% for Epoetin versus 44% for Darbepoetin (p=NS). At 8 weeks, it was 48% and 60%, respectively (p=NS). QOL analysis unexpectedly showed that fatigue and emotional scores were worse in Group B than in Group A. Whether this, not easily explainable observation, is just an incidental finding remains to be shown in larger series. CONCLUSIONS: QW Darbepoetin is a convenient therapy and it induced haemoglobin changes of similar magnitude to TIW Epoetin.

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Issue

Vol. 1 No. 1 (2006)

Section

ORIGINAL ARTICLES

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