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Procrit Does Not Reduce Need for Transfusion in Critically Ill

May lower mortality in trauma patients and increase thrombotic events

WEDNESDAY, Sept. 5 (HealthDay News) -- Procrit (epoetin alfa) does not reduce the need for a blood transfusion in patients in the intensive care unit, although it may lower mortality in trauma patients and increase hemoglobin concentration and thrombotic events, according to the results of a trial published in the Sept. 6 issue of the New England Journal of Medicine.

Howard L. Corwin, M.D., from Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues randomized 1,460 medical, surgical and trauma patients admitted to intensive care units to recombinant human erythropoietin (epoetin alfa, 40,000 U) or placebo weekly for a maximum of three weeks. All patients had a hemoglobin concentration of less than 12 g per deciliter.

The researchers found that during a follow-up of 140 days, both groups had similar numbers of patients who received a red-cell transfusion and a similar mean number of red cells transfused. The hemoglobin concentration increased significantly and mortality tended to be lower (adjusted hazard ratio 0.86) in patients receiving epoetin alfa, particularly those with trauma (adjusted hazard ratio 0.40). However, epoetin alfa increased the risk of thrombotic events (hazard ratio 1.41).

"Without a clear indication for initiating erythropoietin in all critically ill patients, new prescriptions for this drug should be restricted to randomized trials with independent research oversight carefully examining fatal and non-fatal clinically important outcomes," Deborah Cook, M.D., and Mark Crowther, M.D., from McMaster University in Hamilton, Ontario, Canada, write in an accompanying editorial.

The study was funded by Johnson & Johnson Pharmaceutical Research and Development.

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