PURPOSE: This analysis of ASSESS, a multicenter, retrospective hospital chart review, evaluated patient characteristics, dosing patterns and hemoglobin (Hb) outcomes associated with erythropoiesis-stimulating protein (ESP) use in anemic, hospitalized surgical patients.
METHODS: Data were abstracted from charts of adult hospitalized surgical patients not requiring hemodialysis. Nine hospitals used darbepoetin alfa (DA); 10 used Epoetin alfa (EA). Attempts were made to balance hospital type, number of beds, and trauma center designation. Eligible patients were hospitalized ≥24 hrs; had received ≥1 dose of either ESP (but not both) in the hospital; had ≥2 Hb measurements (1 before and 1 after the first dose).
RESULTS: Mean (SD) baseline Hb closest to but before the first ESP dose was 9.2 (1.9) and 9.5 (1.5) g/dL in patients receiving DA (n=209) or EA (n=307), respectively. The most common surgeries for DA and EA patients were pulmonary- (29% and 25%, respectively) and gastrointestinal/abdominal-related (28% and 21%, respectively). Patients received a median (25%, 75%) dose of 53 (33, 82) mcg of DA or 18667 (10000, 30000) IU of EA per week of hospital stay. Of patients receiving DA, 85% were prescribed once-weekly dosing; of EA patients, 36% were prescribed thrice-weekly and 30% once-weekly dosing. The mean (SD) change in Hb from baseline to discharge was 0.7 (1.6) and 0.5 (1.7) g/dL for patients receiving DA or EA, respectively; the median (25%, 75%) length of hospital stay was 22 (13, 40) and 15 (9, 27) days, respectively. Transfusion independence after ESP initiation was achieved by 50% of DA and 53% of EA patients.
CONCLUSION: Based on descriptive statistics, and despite a longer length of stay for DA-receiving patients suggesting a more complicated patient population, Hb outcomes and transfusion independence associated with the reported ESP doses were similar from a clinical perspective for hospitalized surgical patients receiving DA or EA.
CLINICAL IMPLICATIONS: Provides a better understanding of dosing patterns and clinical outcomes associated with ESP use, which is not well characterized in the treatment of anemia in hospitalized surgical patients.
DISCLOSURE: Lawrence Lottenberg, Grant monies (from industry related sources) L. Lottenberg, Amgen Inc. GM Brophy, Amgen Inc. MJ Shapiro, Amgen Inc.; Shareholder D. Scarlata, Amgen Inc. P. Audhya, Amgen Inc. Wife of L. Lottenberg, Amgen Inc.; Employee D. Scarlata, Amgen Inc. P. Audhya, Amgen Inc. Wife of L. Lottenberg, Amgen Inc.; Consultant fee, speaker bureau, advisory committee, etc. G.M. Brophy, Amgen Inc. and Ortho Biotech; Product/procedure/technique that is considered research and is NOT yet approved for any purpose, Inpatient use of darbepoetin alfa and Epoetin alfa for the treatment of anemia after surgery.