National Institute for Health and Clinical Excellence (NICE)
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NICE issues guidance on the use of erythropoietin analogues for anaemia induced by cancer treatment

The National Institute for Health and Clinical Excellence (NICE) yesterday (28 May 2008) published guidance on the use of epoetin (alpha and beta) and darbepoetin for the treatment of cancer-treatment induced anaemia.

Erythropoietin analogues with iron injections are recommended as a possible treatment for anaemia caused by cancer treatment only in:

• women receiving platinum-based chemotherapy for cancer of the ovaries who have a blood haemoglobin level of 8 g/100 ml or lower

• people who have very severe anaemia and cannot receive blood transfusions.

Healthcare professionals should not stop prescribing erythropoietin analogues for people who were already taking them when the guidance was issued. These people should be able to carry on taking erythropoietin analogues until they and their healthcare professionals decide that it is the right time to stop treatment.

Andrew Dillon, NICE Chief Executive, said: “Our independent advisory committee has recommended the use of erythropoietin analogues for patients who are unable to be given blood transfusions and who experience profound anaemia that is considered likely to have an impact on survival. The committee has also recommended the use of erythropoietin analogues for a specific sub group of patients with ovarian cancer who are receiving platinum-based chemotherapy and who have symptomatic anaemia with a haemoglobin level of 8 g/100 ml or lower.

Notes for editors

About this appraisal

1. The three drugs being considered in this appraisal are epoetin alfa, epoetin beta and darbepoetin alfa. Erythropoietin analogues are an addition to, rather than a complete replacement for, existing components of the management of anaemia induced by cancer treatment. Blood transfusion in particular may still be required.

2. During this appraisal the regulatory health authorities have conducted reviews into the safety of erythropoietin analogues. This guidance was produced taking the conclusions of those reviews into consideration, and should be read in conjunction with the reports published by the regulatory health authorities.

About NICE


3. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

4. NICE produces guidance in three areas of health:

public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector

health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS

clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

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