Scientists at UT Southwestern Medical Center have observed that patients with diabetes, kidney disease and anemia who don't respond to treatment with an anti-anemia drug have a higher risk of cardiovascular disease or death. The findings suggest that testing such patients' responsiveness to the drug and keeping blood iron levels a little low might reduce their risk, said Robert Toto, senior author of the study.
The results were an unexpected finding of a study on darbepoetin alpha, which stimulates the production of red blood cells to counteract anemia.
The study showed that darbepoetin alpha works no better than a placebo for improving cardiovascular and kidney outcomes, but it did lower the risk for blood transfusion and resulted in modest improvement in patient-reported outcomes among people with diabetes, kidney disease and anemia.
However, people receiving darbepoetin alpha had nearly a twofold higher risk for stroke. Cancer deaths were also higher among people receiving the drug.
The study included 4,038 participants, all of whom had type 2 diabetes, anemia and kidney damage, although not enough to require dialysis. Of these, 1,872 received injections of the drug, and 1,889 received placebo injections.
Participants receiving darbepoetin alpha also received periodic subcutaneous injections of the drug with the aim of increasing their levels of hemoglobin to a level of 13 grams per deciliter.
In analyzing the results, the researchers found that the participants who had poor initial responses to the drug had a higher rate of death, heart attack, stroke or heart failure.
Conversely, for patients who respond quickly to the drug appears safer, Toto said.
The findings appeared in the New England Journal of Medicine.