Darbepoetin Alfa for Anemia in HF: No Clinical Benefit, Possible Harm

Erythropoiesis stimulation corrects the hemoglobin deficiency but fails to improve mortality or hospitalization rates and may increase thromboembolic risk.

In patients with heart failure (HF), anemia is common and associated with worse symptoms and increased mortality. To determine whether therapy to reverse anemia improves outcomes, investigators for the manufacturer-sponsored, international, randomized, double-blind, RED-HF trial studied the effects of darbepoetin alpha, an erythropoiesis-stimulating agent (ESA), on clinical outcomes in 2278 adults (mean age, 72; 41% women) with symptomatic systolic HF and anemia, defined as a hemoglobin level of 9.0–12.0 g/dL. Patients were assigned to receive placebo or darbepoetin alpha injections every 2 weeks until hemoglobin levels reached 13.0, followed by monthly maintenance doses. Those with evidence of iron deficiency received supplemental iron.

The…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)