Anemia: Fast Facts (Peer reviewed publications)
The National Anemia Action Council, Inc reports on a research initiative: Providing recommendations for the identification, diagnosis, and management of anemia
The National Anemia Action Council, Inc. funded a research initiative intended to improve outcomes by providing recommendations for the identification, diagnosis, and management of anemia. Following a systematic literature review, a panel of 9 physicians ranked 336 clinical scenarios as 'appropriate', 'uncertain', or 'inappropriate'. An interactive version of the guidelines is available at http://www.anemia.org; click on Anemia Guidelines). It was determined that primary care physicians should obtain screening blood counts, perform diagnoses, and manage anemia in patient groups known to be at risk.
To view this abstract and/or order this article, go to: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract
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Source Document: Dubois RW, Goodnough LT, Ershler WB, Van Winkle L, Nissenson AR. Identification, diagnosis, and management of anemia in adult ambulatory patients treated by primary care physicians: evidence-based and consensus recommendations.
Curr Med Res Opin. 2006;22:385-95
The Society for the Advancement of Blood Management provides recommendations for anemia in the elective surgical patient
The Society for the Advancement of Blood Management (www.sabm.org) published a clinical care pathway for the detection, evaluation, and management of anemia in the elective surgical patient with the hopes of improving patient outcomes. A panel of physicians convened, reviewed the evidence, and developed recommendations in order to standardize the clinical approach for anemia management in this clinical setting. It was determined that a patient scheduled for elective surgery should have their hemoglobin level measured 30 days prior to the scheduled procedure in order to detect and evaluate the anemia and/or underlying comorbidities. The panel determined it is appropriate to defer elective surgery in the setting of unexplained anemia until an appropriate workup can be accomplished.
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract
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Source document: Goodnough LT, Shander A, Spivak JL, Waters JH, Friedman AJ, Carson JL, Keating EM, Maddox T, Spence R. Detection, evaluation, and management of anemia in the elective surgical patient. Anesth Analg. 2005;101:1858-61
Results of a randomized controlled trial conducted on patients with chemotherapy-induced anemia
A randomized, double-blind, double-dummy, active-controlled phase 3 trial was performed and the incidence of red blood cell transfusion was compared in two groups. A total of 705 patients were randomized (1:1) to one of two groups dosed for 15 weeks with either darbepoietin alfa 500 mcg every 3 weeks or weekly administration of darbepoietin alfa 2.25 mcg every week (672 remained in study at week 5). The study demonstrated from week 5 to the end of the treatment phase fewer patients received blood transfusions in the every-3-week arm than in the weekly arm received blood transfusions (unadjusted Kaplan-Meier estimates = 23% versus 30%, difference = -6.8%; 95% CI = -13.6 to 0.1). A total of 84% of patients in the every-3 week dosing group achieved their target hemoglobin level of >/= 11 g/dL vs. 77% in the every week dosing group. The researchers concluded patients with chemo-induced anemia can safely and effectively be treated with 500 mcg darbepoietin alfa every 3 weeks.
A total of 705 patients were randomly assigned, and 672 remained in the study at week 5. Percentages of patients achieving the target hemoglobin level (> or = 11 g/dL, consistent with evidence-based practice guidelines) were 84% (every 3 weeks) and 77% (weekly). The frequency of cardiovascular/thromboembolic adverse events was 8% in both groups, and safety was comparable.
To view this abstract and/or order this article, go to:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract
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Source document: Canon JL, Vansteenkiste J, Bodoky G, Mateos MV, Bastit L, Ferreira I, Rossi G, Amado RG. Randomized, double-blind, active-controlled trial of every-3-week darbepoetin alfa for the treatment of chemotherapy-induced anemia. J Natl Cancer Inst. 2006;98:273-84
Randomized, open-label study compares efficacy of IV iron with oral iron in treatment of anemia in pregnancy
Al et al studied the efficacy of IV iron in the treatment of anemia in pregnancy. Efficacy of treatment was assessed by measuring the hemoglobin and ferritin levels on the 14th and 28th days, at delivery, and 1 day postpartum. There was a significant variance in hemoglobin levels between groups with time (interaction effect, P<.001), and change in hemoglobin from baseline was lower in the oral group than in the intravenous group on each efficacy measurement, with changes significantly higher on days 14 (P=.004) and 28 (P=.031). Furthermore, patients receiving IV iron throughout the pregnancy had higher ferritin values. There were no differences recorded between both groups with respect to fetal weight and hospitalization time. The researchers concluded intravenous iron treated iron-deficiency anemia of pregnancy and restored iron stores faster and more effectively than oral iron, with no serious adverse reactions.
To view this abstract and/or order this article, go to: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract
&list_uids=16319260&itool=iconabstr&query_hl=9&itool=pubmed_docsum
Source document: Al RA, Unlubilgin E, Kandemir O, Yalvac S, Cakir L, Haberal A. Intravenous versus oral iron for treatment of anemia in pregnancy: a randomized trial. Obstet Gynecol. 2005;106:1335-40
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