Study: Anemia drugs increase risk of blood clots

Medications frequently given to cancer patients to reduce their risk of anemia are associated with an increased risk of blood clots, according to a study published this week in the Journal of the National Cancer Institute. Anemia drugs, known as erythropoiesis-stimulating agents (ESAs), such as epoetin alfa (Epogen) and darbepoetin alfa (Aranesp), stimulate red blood cell production and are intended to reduce the number of blood transfusions required during chemotherapy.

Researchers at Columbia University Medical Center in New York analyzed the association between ESA use and the formation of blood clots (deep vein thrombosis or pulmonary embolism) and overall survival in patients who were 65 years or older and who received chemotherapy for colon, non-small cell lung, or breast cancer or diffuse large B-cell lymphoma from 1991 to 2002. Patients who took an ESA drug had an increased risk of deep vein thrombosis or pulmonary embolism compared to patients who did not take an ESA, though overall survival was similar in both groups.

 Read on for more detailed information on the risks associated with using anemia drugs, which can include blood clots, cancer progression, and death. In 2008, the Food and Drug Administration issued a black-box warning on darbepoetin alfa and epoetin alfa, and suggested limiting the use of ESAs to specific tumor types, durations, and targeted hemoglobin levels.

CR’s take: If you and your doctor are considering using an ESA, whether for cancer, kidney disease, or other uses, weigh the benefits against the potential risks. Take a look our guidelines for patients considering the use of ESAs and be sure to fully discuss these with your doctor.

—Ginger Skinner

Learn how to recognize the symptoms of a blood clot, and for more on anemia drugs, read our report.