Erythropoietin And/Or Iron Sucrose For Perioperative Anemia Management In Hip and Knee Arthroplasty

Anemia, Iron Deficiency Clinical Trial

Official title:

Efficacy and Safety of Erythropoietin And/Or Intravenous Iron Sucrose For Treatment of Anemia In Hip and Knee Arthroplasty: A Single-center Retrospective Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03917394
• Other study ID #: EPO-retro-cohort-PUMCH
• Status: Recruiting
• Start date: April 24, 2019
• Est. completion date: September 30, 2019

Study information

• Verified date: April 2019
• Source: Peking Union Medical College Hospital
• Contact: Wei Wang, PhD
• Phone: 86-18612672533
• Email: wangwei4531[@]pumch.cn
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Perioperative anemia is very common in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study retrospectively analyzes the use of rHuEPO and iron sucrose in patients undergoing total hip and knee arthroplasty in order to observe the short-term efficacy and safety of rHuEPO and iron sucrose.

Description:

This study aims to explore whether short-term use of rHuEPO and iron sucrose can improve postoperative anemia and promote postoperative rehabilitation after hip and knee arthroplasty. According to different therapies of perioperative anemia , included subjects would be divided into rHuEPO monotherapy group, iron sucrose monotherapy group, rHuEPO combined with iron sucrose group and control group (without rHuEPO and iron sucrose).

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 780
• Est. completion date: September 30, 2019
• Est. primary completion date: May 30, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

1. Patients who underwent hip or knee arthroplasty between May 1, 2012 (included) and December 31, 2015 in Peking Union Medical College Hospital

2. Age = 18 years, sex unlimited

Exclusion Criteria:

1. Patients with serious absence of clinical data

2. Patients with rHuEPO contraindication

1. Patients with uncontrolled severe hypertension

2. Patients allergic to this product and other mammalian cell derivatives, or to human serum albumin

3. Co-infected patients

3. Patients definitely allergic to iron sucrose injection

4. Patients with coagulation dysfunction

Related Conditions & MeSH terms

• Anemia
• Anemia, Iron Deficiency
• Anemia, Iron-Deficiency

Intervention

Drug:
• rHuEPO
rHuEPO was administrated daily with 10000 IU or 20000 IU
• Iron sucrose
Iron sucrose was administrated daily with 100mg or 200mg

Locations

Country	Name	City	State
China	Peking Union Medical College Hospital	Beijing	Beijing

Sponsors (1)

Lead Sponsor	Collaborator
Peking Union Medical College Hospital

Country where clinical trial is conducted

China, 

References & Publications (12)

Bou Monsef J, Boettner F. Blood management may have an impact on length of stay after total hip arthroplasty. HSS J. 2014 Jul;10(2):124-30. doi: 10.1007/s11420-014-9384-x. Epub 2014 Apr 8. — View Citation

Clevenger B, Richards T. Pre-operative anaemia. Anaesthesia. 2015 Jan;70 Suppl 1:20-8, e6-8. doi: 10.1111/anae.12918. Review. — View Citation

Conlon NP, Bale EP, Herbison GP, McCarroll M. Postoperative anemia and quality of life after primary hip arthroplasty in patients over 65 years old. Anesth Analg. 2008 Apr;106(4):1056-61, table of contents. doi: 10.1213/ane.0b013e318164f114. — View Citation

Crosby E. Perioperative use of erythropoietin. Am J Ther. 2002 Sep-Oct;9(5):371-6. Review. — View Citation

Li Y, Yin P, Lv H, Meng Y, Zhang L, Tang P. A meta-analysis and systematic review evaluating the use of erythropoietin in total hip and knee arthroplasty. Ther Clin Risk Manag. 2018 Jul 10;14:1191-1204. doi: 10.2147/TCRM.S159134. eCollection 2018. Review. — View Citation

Lin DM, Lin ES, Tran MH. Efficacy and safety of erythropoietin and intravenous iron in perioperative blood management: a systematic review. Transfus Med Rev. 2013 Oct;27(4):221-34. doi: 10.1016/j.tmrv.2013.09.001. Epub 2013 Oct 15. Review. — View Citation

Muñoz M, Acheson AG, Auerbach M, Besser M, Habler O, Kehlet H, Liumbruno GM, Lasocki S, Meybohm P, Rao Baikady R, Richards T, Shander A, So-Osman C, Spahn DR, Klein AA. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia. 2017 Feb;72(2):233-247. doi: 10.1111/anae.13773. Epub 2016 Dec 20. — View Citation

Muñoz M, Gómez-Ramírez S, Cuenca J, García-Erce JA, Iglesias-Aparicio D, Haman-Alcober S, Ariza D, Naveira E. Very-short-term perioperative intravenous iron administration and postoperative outcome in major orthopedic surgery: a pooled analysis of observational data from 2547 patients. Transfusion. 2014 Feb;54(2):289-99. doi: 10.1111/trf.12195. Epub 2013 Apr 15. — View Citation

Na HS, Shin SY, Hwang JY, Jeon YT, Kim CS, Do SH. Effects of intravenous iron combined with low-dose recombinant human erythropoietin on transfusion requirements in iron-deficient patients undergoing bilateral total knee replacement arthroplasty. Transfusion. 2011 Jan;51(1):118-24. doi: 10.1111/j.1537-2995.2010.02783.x. — View Citation

Tran DH, Wong GT, Chee YE, Irwin MG. Effectiveness and safety of erythropoiesis-stimulating agent use in the perioperative period. Expert Opin Biol Ther. 2014 Jan;14(1):51-61. doi: 10.1517/14712598.2014.858116. Epub 2013 Nov 13. Review. — View Citation

Voorn VM, van der Hout A, So-Osman C, Vliet Vlieland TP, Nelissen RG, van den Akker-van Marle ME, Dahan A, Marang-van de Mheen PJ, van Bodegom-Vos L. Erythropoietin to reduce allogeneic red blood cell transfusion in patients undergoing total hip or knee arthroplasty. Vox Sang. 2016 Oct;111(3):219-225. doi: 10.1111/vox.12412. Epub 2016 Jun 17. Review. — View Citation

Watts CD, Pagnano MW. Minimising blood loss and transfusion in contemporary hip and knee arthroplasty. J Bone Joint Surg Br. 2012 Nov;94(11 Suppl A):8-10. doi: 10.1302/0301-620X.94B11.30618. Review. — View Citation

* Note: There are 12 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Differences in changes of Hb level in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Changes of Hb level =Hb level in postoperative 7d - Hb level in operation day	Operation day to postoperative day 7
Secondary	Differences in change of red blood cells count(RBC) in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Changes of RBC =RBC in postoperative day 7 - RBC in operation day	Operation day to postoperative day 7
Secondary	Differences in change of hematokrit (HCT) in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Changes of HCT =HCT level in postoperative day 7 - HCT level in operation day	Operation day to postoperative day 7
Secondary	Differences in change of allogeneic transfusion rate(%) in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Transfusion rate is defined as the ratio of numbers subjected to blood transfusion in each group subjects.; Blood transfusion volume is defined as the amount of blood transfusion during operation day and postoperative period.	Operation day to postoperative day 7
Secondary	Differences in change of allogeneic blood transfusion volume in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Allogeneic blood transfusion volume is defined as the amount of blood transfusion volume from operation day to postoperative day 7 Blood transfusion volume is defined as the amount of blood transfusion during operation day and postoperative period.	Operation day to postoperative day 7
Secondary	Difference in postoperative hospital days in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Postoperative hospital days is defined as the number of days from operation day to hospital discharge.	Up to 4 months
Secondary	Comparing differences of blood loss volume in each group.	Blood loss volume is defined as the total volume of intraoperative bleeding and postoperative drainage.	Operation day to postoperative day 7
Secondary	Comparing the rate of anemia between operation day and post-operation day 7 in each group.	According to 2011 World Health Organization(WHO) anemia standard,Hb< 130g/L for adult men and Hb < 120g/L for non-pregnant women are defined as anemia.	Operation day to postoperation day 7
Secondary	Differences in changes of platelet count in rHuEPO, iron sucrose, rHuEPO combined with iron sucrose and control group.	Changes of platelet count =platelet count in postoperative 7d - platelet count in operation day	Operation day to postoperative day 7
Secondary	Safety of rHuEPO and/or iron sucrose	Adverse events and serious adverse events	Form operation day to postoperative day 7