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Titolo:
Erythropoietin with iron supplementation to prevent allogeneic blood transfusion in total hip joint arthroplasty - A randomized, controlled trial
Autore:
Feagan, BG; Wong, CJ; Kirkley, A; Johnston, DWC; Smith, FC; Whitsitt, P; Wheeler, SL; Lau, CY; Johnston, W; Beaupre, L; Schaump, L; Bohonis, D; Greaves, K; Rorabeck, C; Bourne, R; Murkin, J; McCalden, R; MacDonald, S; McCabe, C; Smith, F; Dale, NI; Reynolds, L; Whitsitt, P; Rochon, N; Taylor, D; OFarrell, TA; Boyce, D; Pisesky, W; OConnor, G; LeNoble, E; Mantle, M; Bond, D; Turner, K; Bond, P; Swilzer, K; Laflamme, GH; Pynn, B; Dow, G; Steeves, J; Clark, A; Pavlatos-Jones, G; MacLoughlin, C; Laliberte, P; Grenier, A; Chabot, J; Lortie, M; Godin, C; Pynn, B; Waddell, J; Morton, J; Sandler, A; Kaszas, Z; Warriner, B; Werry, D; Metcalfe, C; Tile, M; Dubrovskis, V; Garnett, R; Krepski, B; Cicutti, N; Huk, O; Pynn, B; Wilson, J; Johnston, N; Mulock, R; Sarazin, B; Liddiard, E; Bergman, B; Johnson, W;
Indirizzi:
John P Robarts Res Inst, London Clin Trials Res Grp, London, ON N6A 5K8, Canada John P Robarts Res Inst London ON Canada N6A 5K8 ndon, ON N6A 5K8, Canada Univ Western Ontario, London, ON N6A 3K7, Canada Univ Western Ontario London ON Canada N6A 3K7 London, ON N6A 3K7, Canada Univ Alberta, Edmonton, AB T6G 2M7, Canada Univ Alberta Edmonton AB Canada T6G 2M7 rta, Edmonton, AB T6G 2M7, Canada Sir William Osler Hlth Inst, Hamilton, ON, Canada Sir William Osler Hlth Inst Hamilton ON Canada nst, Hamilton, ON, Canada LakeRidge Hlth Oshawa, Oshawa, ON, Canada LakeRidge Hlth Oshawa Oshawa ONCanada e Hlth Oshawa, Oshawa, ON, Canada Janssen Ortho Inc, Toronto, ON, Canada Janssen Ortho Inc Toronto ON Canada nssen Ortho Inc, Toronto, ON, Canada
Titolo Testata:
ANNALS OF INTERNAL MEDICINE
fascicolo: 11, volume: 133, anno: 2000,
pagine: 845 - 854
SICI:
0003-4819(200012)133:11<845:EWISTP>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
RECOMBINANT-HUMAN-ERYTHROPOIETIN; AUTOLOGOUS BLOOD; ELECTIVE SURGERY; VENOUS THROMBOSIS; DONATION; KNEE; VENOGRAPHY; INFECTION; EFFICACY; EXPOSURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Feagan, BG John P Robarts Res Inst, London Clin Trials Res Grp, Box 5015,100 Perth Dr, London, ON N6A 5K8, Canada John P Robarts Res Inst Box 5015,100 Perth Dr London ON Canada N6A 5K8
Citazione:
B.G. Feagan et al., "Erythropoietin with iron supplementation to prevent allogeneic blood transfusion in total hip joint arthroplasty - A randomized, controlled trial", ANN INT MED, 133(11), 2000, pp. 845-854

Abstract

Background: The optimum regimen of epoetin alfa for prevention of allogeneic blood transfusion is unknown. Objective: To determine whether a modified regimen of epoetin alfa reducesallogeneic blood transfusion in patients undergoing hip arthroplasty. Design: Randomized, double-blind, multicenter trial comparing two modifieddose regimens of epoetin alfa with placebo. Setting: 13 teaching hospitals and 4 community hospitals in Canada. Patients: 201 patients undergoing primary hip arthroplasty who had a hemoglobin concentration of 98 to 137 g/L and did not predonate blood. Intervention: Patients were assigned in a 3:5:5 ratio to receive four weekly doses of epoetin alfa, 40 000 U (high-dose; n = 44) or 20 000 U (low-dose; n = 79), or placebo (n = 78), starting 4 weeks before surgery. All patients received oral iron supplementation, 450 mg/d, for 42 or more days before surgery. Measurements: The primary end point was allogeneic transfusion. Secondary end points were thromboembolic events and change in reticulocyte count and hemoglobin concentration. Results: Both modified epoetin alfa regimens significantly reduced the need for allogeneic transfusion: Five (11.4%) patients in the high-dose group (P = 0.001) and 18 (22.8%) patients in the low-dose group (P = 0.003) had transfusion, compared with 35 (44.9%) patients in the placebo group. The hematologic response was substantial in patients who received epoetin alfa. Inthe high-dose group, low-dose group, and placebo group, the preoperative increase in reticulocyte count was 58.8, 37.0 and 1.8 x 10(9) cells/L (P < 0.004), respectively, and the increase in hemoglobin concentration was 19.5,17.2, and 1.2 g/L (P < 0.001). The incidence of thromboembolic events did not differ among groups. Conclusions: Both modified epoetin alfa regimens were effective compared with placebo in reducing allogeneic transfusion in patients undergoing hip arthroplasty. Patients who received high-dose epoetin alfa had the lowest transfusion rate.

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Documento generato il 04/12/20 alle ore 22:03:37