6/28/23, 12:09 AM CHOIR Pathway Feedback Search Clinical Topics Home Studies CHOIR CHOIR Disease Disease Anemia of chronic kidney disease Chronic kidney disease Trial question What is the role of epoetin alfa in patients with anemia of CKD? Study design Multi-center Open label RCT Population Characteristics of study participants 55.0% female N = 1432 45.0% male 1432 patients (790 female, 642 male) Inclusion criteria: patients with anemia of CKD Key exclusion criteria: uncontrolled hypertension, active gastrointestinal bleeding, an iron- overload state, a history of frequent transfusions in the previous 6 months, refractory iron- deficiency anemia, active cancer, or previous therapy with epoetin alfa Interventions N=715 high-Hgb (administration of epoetin alfa for a target Hgb level of 13.5 g/dL) N=717 low-Hgb (administration of epoetin alfa for a target Hgb level of 11.3 g/dL) Primary outcome Death, myocardial infarction, hospitalization for congestive heart failure, or stroke. 17.5 % 17.5 13.5 13.1 % https://web.pathway.md/studies/recg6srjTwdrFYMbS 1/2 6/28/23, 12:09 AM CHOIR Pathway 8.8 % Significant increase 4.4 % NNH = 25 0.0 % High-hemoglobin Low-hemoglobin Significant increase in death, myocardial infarction, hospitalization for congestive HF, or stroke. (17.5% vs. 13.5%; HR 1.34, 95% CI 1.03 to 1.74) Secondary outcomes No significant difference in death (7.3% vs. 5%; HR 1.48, 95% CI 0.97 to 2.27) No significant difference in hospitalization for congestive HF (9% vs. 6.6%; HR 1.41, 95% CI 0.97 to 2.05) Significant increase in hospitalization for cardiovascular causes (32.6% vs. 27.5%; HR 1.23, 95% CI 1.01 to 1.48) Safety outcomes No significant difference in adverse event and thrombovascular event. Significant difference in serious adverse event (54.8% vs. 48.5%) and congestive HF (11.2% vs. 7.4%). Conclusion In patients with anemia of CKD, high-Hgb was inferior to low-Hgb with respect to death, myocardial infarction, hospitalization for congestive HF, or stroke Reference Singh AK, Szczech L, Tang KL et al. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006 Nov 16;355(20):2085-98. Open reference URL https://web.pathway.md/studies/recg6srjTwdrFYMbS 2/2