Association between serum hepcidin-25 and primary resistance to erythropoiesis-stimulating agents in chronic kidney disease: a secondary analysis of the HERO trial
MetadataShow full item record
Background: Pentoxifylline has been shown to increase haemoglobin levels in patients with chronic kidney disease (CKD) and erythropoietin-stimulating agent (ESA)-hyporesponsive anaemia in the Handling Erythropoietin Resistance with Oxpentifylline multicentre double-blind, randomized controlled trial. The present sub-study evaluated the effects of pentoxifylline on the iron-regulatory hormone hepcidin in patients with ESA-hyporesponsive CKD. Methods: This sub-study included 13 patients in the pentoxifylline arm (400 mg daily) and 13 in the matched placebo arm. Hepcidin-25 was measured by ultra performance liquid chromatography/quadrupole time-of-flight mass spectrometry following isolation from patient serum. Serum hepcidin-25, serum iron biomarkers, haemoglobin and ESA dosage were compared within and between the two groups. Results: Hepcidin-25 concentration at 4 months adjusted for baseline did not differ significantly in pentoxifylline versus placebo treated patients (adjusted mean difference (MD) -7.9 nmol, P = 0.114), although the difference between the groups mean translated into a > 25% reduction of circulating hepcidin-25 due to pentoxifylline compared with the placebo baseline. In paired analysis, serum hepcidin-25 levels were significantly decreased at 4 months compared with baseline in the pentoxifylline group (-5.47 ± 2.27 nmol/l, P < 0.05) but not in the placebo group (2.82 ± 4.29 nmol/l, P = 0.24). Pentoxifylline did not significantly alter serum ferritin (MD 55.4 mcg/l), transferrin saturation (MD 4.04%), the dosage of ESA (MD -9.93 U/kg per week) or haemoglobin concentration (MD 5.75 g/l). Conclusion: The reduction of circulating hepcidin-25 due to pentoxifylline did not reach statistical significance; however, the magnitude of the difference suggests that pentoxifylline may be a clinically and biologically meaningful modulator of hepcidin-25 in dialysis of patients with ESA-hyporesponsive anaemia. © 2016 Asian Pacific Society of Nephrology.
Showing items related by title, author, creator and subject.
Hepcidin predicts response to IV iron therapy in patients admitted to the intensive care unit: A nested cohort studyLitton, E.; Baker, S.; Erber, W.; Farmer, Shannon; Ferrier, J.; French, C.; Gummer, J.; Hawkins, D.; Higgins, A.; Hofmann, A.; De Keulenaer, B.; McMorrow, J.; Olynyk, John; Richards, T.; Towler, S.; Trengove, R.; Webb, S.; Chapman, A.; Jenkinson, E.; Palermo, A.; Roberts, B. (2018)© 2018 The Author(s). Background: Both anaemia and red blood cell (RBC) transfusion are common and associated with adverse outcomes in patients admitted to the intensive care unit (ICU). The aim of this study was to ...
Neratinib after trastuzumab-based adjuvant therapy in patients with HER2-positive breast cancer (ExteNET): A multicentre, randomised, double-blind, placebo-controlled, phase 3 trialChan, Arlene; Delaloge, S.; Holmes, F.; Moy, B.; Iwata, H.; Harvey, V.; Robert, N.; Silovski, T.; Gokmen, E.; von Minckwitz, G.; Ejlertsen, B.; Chia, S.; Mansi, J.; Barrios, C.; Gnant, M.; Buyse, M.; Gore, I.; Smith, J.; Harker, G.; Masuda, N.; Petrakova, K.; Zotano, A.; Iannotti, N.; Rodriguez, G.; Tassone, P.; Wong, A.; Bryce, R.; Ye, Y.; Yao, B.; Martin, M. (2016)Background: Neratinib, an irreversible tyrosine-kinase inhibitor of HER1, HER2, and HER4, has clinical activity in patients with HER2-positive metastatic breast cancer. We aimed to investigate the efficacy and safety of ...
Intravenous iron or placebo for anaemia in intensive care: the IRONMAN multicentre randomized blinded trial: A randomized trial of IV iron in critical illnessThe, I.; Litton, E.; Baker, S.; Erber, W.; Farmer, Shannon; Ferrier, J.; French, C.; Gummer, J.; Hawkins, D.; Higgins, A.; Hofmann, Axel; De Keulenaer, B.; McMorrow, J.; Olynyk, John; Richards, T.; Towler, S.; Trengove, R.; Webb, S.; The, A. (2016)Purpose: Both anaemia and allogenic red blood cell transfusion are common and potentially harmful in patients admitted to the intensive care unit. Whilst intravenous iron may decrease anaemia and RBC transfusion requirement, ...