Evidence map›Paper›PMID 19407261›Full record

SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2009

Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis.

Marcello Tonelli, Brenda Hemmelgarn, Tony Reiman, Braden Manns, M Neil Reaume, Anita Lloyd, Natasha Wiebe, Scott Klarenbach

Erratum issuedOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 62 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 14 pooled it
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 14 syntheses or guidelines pooled it, 197 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pharmacological treatments for fatigue associated with palliative care.The Cochrane database of systematic reviews · 2015
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Erythropoietin or darbepoetin for patients with cancer.The Cochrane database of systematic reviews · 2012
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Guideline
  13. Pooled it
  14. Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Review
  20. Review

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

  • Erratum issued
5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Marcello TonelliDepartment of Medicine, University of Alberta, Edmonton. mtonelli-admin@med.ualberta.ca
Brenda Hemmelgarn
Tony Reiman
Braden Manns
M Neil Reaume
Anita Lloyd
Natasha Wiebe
Scott Klarenbach
University of Alberta · CAUniversity of Calgary · CADalhousie University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundErythropoiesis-stimulating agents are used to treat anemia in patients with cancer. However, their safety and effectiveness is controversial. We did a systematic review of the clinical efficacy and harms of these agents in adults with anemia related to cancer or chemotherapy.

methodsWe conducted a systematic review of published and unpublished randomized controlled trials (RCTs) using accepted methods for literature searches, article selection, data extraction and quality assessment. We included RCTs involving anemic adults with cancer. We compared the use of erythropoiesis-stimulating agents with nonuse and assessed clinical outcomes (all-cause mortality, cardiovascular events and hypertension, health-related quality of life, blood transfusions and tumour response) and harms (serious adverse events) between groups.

resultsWe identified 52 trials (n = 12 006) that met our selection criteria. The pooled all-cause mortality during treatment was significantly higher in the group receiving erythropoiesis-stimulating therapy than in the control group (relative risk [RR] 1.15, 95% confidence interval [CI] 1.03 to 1.29). Compared with no treatment, use of erythropoiesis-stimulating agents led to clinically detectable improvements in disease-specific measures of quality of life. It also reduced the use of blood transfusions (RR 0.64, 95% CI 0.56 to 0.73). However, it led to an increased risk of thrombotic events (RR 1.69, 95% CI 1.27 to 2.24) and serious adverse events (RR 1.16, 95% CI 1.08 to 1.25).

interpretationUse of erythropoiesis-stimulating agents in patients with cancer-related anemia improved some disease-specific measures of quality of life and decreased the use of blood transfusions. However, it increased the risk of death and serious adverse events. Our findings suggest that such therapy not be used routinely as an alternative to blood transfusion in patients with anemia related to cancer.

Indexed as

AnemiaAntineoplastic AgentsBlood TransfusionHematinicsHumansNeoplasmsQuality of LifeRisk FactorsSurvival RateAntineoplastic AgentsHematinics

Identifiers

PMID19407261
PMCPMC2683210
OpenAlexW2145869599

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.