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Treating anemia in heart failure patients: a review of erythropoiesis-stimulating agents.

机译:治疗心力衰竭患者的贫血:促红细胞生成剂的综述。

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摘要

IMPORTANCE OF THE FIELD: Prevalence of chronic heart failure (CHF) is increasing, and despite improvements in the past decade the prognosis in terms of mortality and health-related quality of life remains poor. Anemia is often found concomitantly in CHF patients. AREAS COVERED IN THIS REVIEW: Erythropoiesis-stimulating agents (ESAs) are a new treatment option for these anemic CHF patients, promising to decrease mortality and hospitalizations, and increase health-related quality of life. WHAT THE READER WILL GAIN: CHF epidemiology is briefly discussed. Currently available clinical efficacy and safety data are critically appraised. Health care utilization by CHF patients, particularly hospitalizations, are reviewed in order predict cost-effectiveness of ESAs. TAKE HOME MESSAGES: The efficacy for the most pertinent endpoints has not been proven by a pivotal trial or a meta-analysis free of bias, and there might be increased cardiovascular events and cancer incidence rates above a currently unknown target value or with multiple doses. However, subgroups should be identified in which ESAs might prove to be more efficacious and as safe as usual care and either cost-saving or cost-effective. Nevertheless, depending on the subgroup, the budget effect for payors might be dramatic due to the large number of CHF patients.
机译:领域的重要性:慢性心力衰竭(CHF)的发病率正在增加,尽管在过去十年中有所改善,但死亡率和与健康相关的生活质量方面的预后仍然很差。经常在CHF患者中发现贫血。本综述涵盖的领域:红细胞生成刺激剂(ESA)是这些贫血性CHF患者的新治疗选择,有望降低死亡率和住院率,并提高与健康相关的生活质量。读者的收获:简要讨论CHF流行病学。对目前可获得的临床疗效和安全性数据进行了严格评估。对CHF患者(尤其是住院患者)的医疗保健利用进行了审查,以预测ESA的成本效益。温馨提示:一项关键性试验或无偏倚的荟萃分析尚未证明对大多数相关终点的疗效,并且心血管事件和癌症发生率可能会增加,超过目前未知的目标值或多次给药。但是,应该确定亚组,在这些亚组中,ESA可能被证明比常规护理更有效,更安全,并且既节省成本又具有成本效益。然而,由于亚组的不同,由于CHF患者人数众多,付款人的预算效果可能会非常显着。

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