NEJM -- Efficacy and Safety of Epoetin Alfa in Critically Ill Patients

NEJM -- Efficacy and Safety of Epoetin Alfa in Critically Ill Patients

Results: As compared with the use of placebo, epoetin alfa therapy did not result in a decrease in either the number of patients who received a red-cell transfusion or the mean number of red-cell units transfused.

Conclusions: The use of epoetin alfa does not reduce the incidence of red-cell transfusion among critically ill patients, but it may reduce mortality in patients with trauma. Treatment with epoetin alfa is associated with an increase in the incidence of thrombotic events

Then, in the discussion:

In contrast, [to trauma patients] no significant reduction in mortality was seen among surgical and medical patients receiving epoetin alfa.

and

The use of epoetin alfa is not supported for patients admitted to the ICU with a nontraumatic surgical or medical diagnosis, unless they have an approved indication for epoetin alfa.

^{The only reason I post this is because of the extraordinary amount of money I saw spent on promoting the use of this very expensive drug in the critically ill patient population over the past five or ten years. And, mea culpa, I fell for it, too. It will now, hopefully, dry up as yet another revenue source for these companies as word (slowly) filters out to the critical care community. I'm betting there won't be a full court press to get the word out about this particular article.}

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