Summary

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• Epogen (epoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD) in patients on dialysis and not on dialysis, for the treatment of anemia due to zidovudine in patients with HIV infection, for the treatment of anemia due to the effects of concomitant myelosuppressive chemotherapy with a minimum of two additional months of planned chemotherapy, and for the reduction of allogeneic RBC transfusions in patients undergoing elective, noncardiac, nonvascular surgery.
• This summary is based on the review of six systematic review(s)/meta-analysis(es). ^[1-6]
• Preventing Blood Transfusions: Epoetin alfa may reduce the need for blood transfusions compared to placebo (OR 0.28, 95% CI 0.13 to 0.61; low certainty evidence). However, the comparative effects between different ESAs and epoetin alfa remain uncertain (low to very low certainty evidence).
• Hemoglobin Levels: Roxadustat increases hemoglobin levels more effectively than ESAs (epoetin alfa or darbepoetin alfa) and placebo (WMD: 0.82 g/dL; 95% CI: 0.43-1.21), with significant improvements observed in NDD-CKD patients when compared to both placebo (SMD 1.57, 95% CI 1.17-1.98) and epoetin alfa (SMD 0.47, 95% CI 0.02-0.93).
• Iron Metabolism: Roxadustat improves iron metabolism markers, including increasing transferrin and TIBC levels while reducing hepcidin, ferritin, and TSAT levels in NDD-CKD patients; these effects were not observed in DD-CKD patients.
• Epoetin alfa may increase the odds of hypertension compared to placebo (OR 2.10, 95% CI 1.22 to 3.59; very low certainty evidence).
• Roxadustat was associated with an increased incidence of serious treatment-emergent adverse events (TEAEs) in non-dialysis-dependent chronic kidney disease (NDD-CKD) patients (OR: 1.15; 95% CI: 1.02-1.29) and a higher incidence of adverse events compared to epoetin alfa (RR: 1.25, 95% CI 1.01-1.54; low-quality evidence).
• There is no population types or subgroups information available in the reviewed studies.