| 2009: a requiem for rHuEPOs--but should we nail down the coffin in 2010? | |
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MedLine Citation:
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PMID: 20413441 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The recombinant human erythropoietins and allied proteins (epoetin alfa, attempted copies and biosimilar variants of epoetin alfa, epoetin beta, epoetin delta, epoetin zeta, epoetin theta, epoetin omega, darbepoetin alfa, and methoxy-polyethylene glycol-epoetin beta) are among the most successful and earliest examples of biotechnologically manufactured products to be used in clinical medicine. This article charts a brief history of their use in clinical medicine, mainly dealing with chronic kidney disease, paying special attention to how these agents were introduced into clinical medicine and what has happened subsequently; in 2009, there were several developments that could be regarded as a "perfect storm" in terms of the long-term use of these compounds in chronic kidney disease and oncology and, likely, elsewhere. We are now very much at a "crossroads," where mature reflection is required, because with the latest trials and meta-analyses, these therapies seem not only expensive but also very much a clinical tradeoff (increased risk of adverse effects versus a small gain in fatigue scores). How we arrived at this crossroads is a useful illustration of how easy it is, without properly designed randomized, controlled trials, to assume that clinical benefit must follow therapeutic interventions. |
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Authors:
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David Goldsmith |
Publication Detail:
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Type: Historical Article; Journal Article; Review Date: 2010-04-22 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-10 Completed Date: 2010-08-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 929-35 Citation Subset: IM |
Affiliation:
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Renal Department, Guy's Hospital, King's Health Partners, London, United Kingdom. david.goldsmith@gstt.nhs.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anemia
/
blood,
complications,
drug therapy*,
history Biological Markers / blood Erythropoiesis / drug effects* Erythropoietin, Recombinant / adverse effects, history, therapeutic use* Evidence-Based Medicine Hematinics / adverse effects, history, therapeutic use* Hemoglobins / metabolism History, 20th Century History, 21st Century Humans Kidney Failure, Chronic / blood, complications, drug therapy*, history Randomized Controlled Trials as Topic Risk Assessment Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Erythropoietin, Recombinant; 0/Hematinics; 0/Hemoglobins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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