Erythropoietin for patients with malignant disease

Estimating the mean and variance from the median, range, and the size of a sample

“…Due to lack of available methods to use median values, the authors of this important review, decided not to use these papers in their meta-analysis. Recently, the Cochrane review was published attempting to provide more updated analysis of the effects of Epo in anemia related to malignancy [5]. The Cochrane reviewers did meta-analyze data to calculate an average weighted mean increase in hemoglobin as the result of Epo treatment.…”

Recombinant human epoetin beta in the treatment of chemotherapy-related anemia

“…The efficacy of epoetin beta in achieving hematological response and reducing transfusion requirements in patients receiving cancer treatment has been well defined in several randomized studies14,27–34 and meta-analyses 35–38. An example is the recently reported BRAVE trial which randomly assigned 463 woman receiving chemotherapy for metastatic breast cancer to epoetin-beta or supportive care 34.…”

“…A recent Health Technology Assessment commissioned by the United Kingdom National Institute for Health Research (which itself updated an earlier Cochrane review35) considered 46 RCTs containing 7304 patients comparing ESAs plus supportive care versus supportive care alone 38. The majority of trials utilized ESAs in conjunction with anti-cancer therapy although 4 trials included patients receiving no anti-cancer therapy.…”

“…These include FACT (Functional Assessment of Cancer Treatment) questionnaires incorporating additional questions relating to fatigue (FACT-F) or anemia (FACT-An), visual analogue scales and other questionnaires such as SF-36. 35 Although interesting, initial reports of improved QoL were based on open label single arm studies and thus comprised only low level evidence 40,41. However, subsequent double-blind randomized placebo-controlled studies have confirmed improvements in QoL with ESA therapy (summarized by Wilson and colleagues38).…”

Effect of Treatment with Epoetin Beta on Thromboembolic Events in Anemic Patients with Cancer: A Metaanalysis

“…3,5,6,9,10 An independent metaanalysis including 3287 patients from 27 trials conducted before the end of 2001 showed this increased risk to be nonsignificant when epoetins are administered in accordance with current treatment guidelines. 11 However, a follow-up metaanalysis that included additional trials reported before the end of April 2005 (in total, 9353 patients from 57 trials were included) suggested a significant association between epoetin and darbepoetin use and the risk of TEEs (relative risk, 1.67; 95% confidence interval, 1.35-2.06). The authors suggested that the excess risk could be explained by several of the newer trials enrolling nonanemic patients and/or treating patients to higher target Hb levels than those recommended in the current product labels of these agents.…”