Renal Cell Live!

Sunday, March 18, 2007

Alphabet Soup: EPO and FDA

This will be quick; we leave shortly for Cleveland and appointments tomorrow.

Aranesp and other EPO drugs (synthetic erythropoietin, a hormone produced by the kidney that stimulates red blood cell production) have been shown to lead to increased risk of heart problems in dialysis patients, when used to combat anemia. The risk is severe enough to prompt the FDA to require the dreaded "black box warning". The drugs were approved, in fact, to reduce the need for blood transfusions (maintaining the hemoglobin level at 10-11), not to prevent anemia (hemoglobin level at 12 and above), though they are effective at both results. Oncologists have prescribed EPO at higher dosages to alleviate anemia in cancer patients; certainly I took it for 2 years for that reason.

According to a NY Times article, the American Society of Clinical Oncologists (ASCO) has issued a directive to its members to cease prescribing, and Medicare will no longer cover the use of these drugs to combat anemia in cancer patients. How long will it be before insurance companies follow suit?

As one of my fellow RCC patients commented, "This is sad ... It seemed like these drugs were addressing the issue. What will people do now?" I'll be asking Dr G tomorrow - will there be any "slack" cut for patients with RCC, whose anemia may result equally from cancer and renal problems?

To quote the King of Siam, "It's a puzzlement!"

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