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Information for Physicians and Patients

Cochrane Collaboration

Update 01-31-2008

The Cochrane Collaboration is an international not-for-profit organization that provides information and analyses on a broad range of health care issues. Here is a link to a summary of the review they conducted of 57 ESA clinical trials, updated as of May 2006 http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003407/frame.html. The full review can be purchased online at their website for US$ 29.95. Here is an excerpt from the "plain English" version of the authors' conclusions, quoted from the free summary available at the link:

"This review showed consistent evidence that Epo/Darbepo reduces the risk for blood transfusions and the number of units transfused in anaemic cancer patients. Quality of life might be improved following Epo/Darbepo treatment. However, the risk for thrombotic complications is increased and it remains uncertain whether and how Epo/Darbepo effects tumour control and survival."

Update 03-03-2008

The Cochrane Collaboration published an additional meta-analysis in January 2008 to assess the value of drug therapy for the management of cancer-related fatigue (CRF). The text of this publication is available for purchase at http://www.cochrane.org/reviews/en/ab006704.html.

The free summary includes the following authors' conclusions:

"Erythropoietin and darbopoetin (for anaemic patients on chemotherapy) and psychostimulant trials provide evidence for improvement in CRF at a clinically meaningful level. There are no data to support the use of paroxetine or progestational steroids for the treatment of CRF. The obvious candidate drug for use in a large scale RCT is methylphenidate to confirm the preliminary results from this review."