A Cochrane review included 91 studies with a total of 20 101 subjects to assess the effects of recombinant human erythropoiesis-stimulating agents (ESAs) to either prevent or treat anaemia in cancer patients. Studies evaluating the use of ESAs to prevent or reduce anaemia in cancer patients, given singly or concomitantly with chemotherapy, radiotherapy or combination therapy were included.
Hematologic response, need for red blood cell (RBC) transfusions, overall survival and on-study mortality were primary endpoints. The main findings are given in Table 1.
| Outcome | Number of participants (studies) | Assumed risk (control) | Corresponding risk (erythropoietin or darpoietin) | Relative effect (95% CI) |
|---|---|---|---|---|
| Patients receiving RBC transfusions | 15 877 (70) | 389 per 1000 | 195 per 1000 (186 to 204 per 1000) | RR 0.65 (0.62 to 0.68) |
| Overall survival | 19 003 (78) | 142 per 1000 | 149 per 1000 (142 to 156 per 1000) | HR 1.05 (1 to 1.11) |
| On-study mortality | 15 935 (70) | 59 per 1000 | 69 per 1000 (62 to 75 per 1000) | HR 1.17 (1.06 to 1.29) |
| Thrombotic events | 15278 (57) | 46 per 1000 | 70 per 1000 (61 to 80 per 1000) | RR 1.52 (1.33 to 1.73) |