A Study to Evaluate the Safety of Epoetin Alfa and Its Effectiveness in Facilitating the Presurgical Collection of Blood From Anemic Patients for Possible Self-transfusion During and After Scheduled Joint Surgery.

Study Overview
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Brief Summary
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The purpose of this study is to evaluate the safety of epoetin alfa and its effectiveness in facilitating the presurgical collection of blood from anemic patients for possible self-transfusion during and after scheduled joint surgery and its effectiveness in reducing surgery-related transfusion requirements. Epoetin alfa is a genetically engineered protein that stimulates red blood cell production.

Detailed Description
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Major surgical procedures may require transfusion of several units of blood. Blood transfusions from other people may be associated with transfusion reactions that cause fever or infections such as hepatitis or AIDS that are carried (and donated) in blood. However, self-donations of blood may cause anemia in a patient who will be undergoing surgery a few weeks later. Previous research with epoetin alfa suggests that epoetin alfa increases the rate of red blood cell production and decreases anemia. This randomized, double-blind, placebo-controlled, multicenter study is designed to determine whether epoetin alfa in patients with low hematocrit (red blood cell percentage <39 percent) will stimulate the bone marrow to produce red blood cells and therefore increase a patient's ability to self-donate blood prior to major surgery for joint diseases. Patients will be randomly assigned to receive either 600 units of epoetin alfa per kilogram of body weight or matching placebo, injected into a vein on the first study day, and every 3 to 4 days thereafter for 21 days. Effectiveness will be determined by the number of units of self-donated blood collected, the number of units of donor blood used at the time of surgery, and the red blood cell percentages just before surgery. Safety evaluations including the incidence of adverse events, physical examinations, and clinical laboratory tests will be performed throughout the study. The study hypothesis is that patients treated with epoetin alfa will be able to donate more units of blood during the 3 weeks prior to surgery, will need fewer donor-donated units of blood, and will have a higher level of red blood cells than patients who receive placebo. 600 units of epoetin alfa per kilogram of body weight, or an equivalent volume of placebo, injected into a vein every 3 to 4 days for 21 days (6 doses) during the period before surgery.

Official Title
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A Double-Blind, Placebo-Controlled Study to Determine Whether R-HuEPO Can Facilitate Presurgical Autologous Blood Donation in Patients With Low Hematocrit Levels

Conditions
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Anemia

Intervention / Treatment
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* Drug: epoetin alfa


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for surgery involving the joints, 25 to 35 days after starting epoetin alfa therapy having a hematocrit (percentage of red cells in the blood) of <=39% in good general health. Exclusion Criteria: Patients with a history of any primary blood disease having a history of artery blockage in the heart, body or brain, a history of seizures, uncontrolled high blood pressure, or active inflammatory disease, (except osteoarthritis or rheumatoid arthritis) losing blood internally from the stomach or intestines or elsewhere in the body using of any cell toxic drug, drugs that suppress the immune system, or drugs known to influence red blood cell production (such as chemotherapy for cancer) within 1 month of therapy having a folate or vitamin B12 deficiency, iron-deficiency anemia, or a disease that destroys blood cells.

Ages Eligible for Study
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Minimum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: epoetin alfa|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of units of blood self-donated; Number of donor-donated units of blood used; Total red blood cell volume; Total red blood cell production; Change in hemoglobin from baseline to after the final dose of study medication, but before surgery |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total transfusion requirements at the time of surgery; incidence of adverse events |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anemia, blood transfusion, epoetin alfa, erythropoietin, surgery, blood donation, blood