Patient-Reported Fatigue Scores in Cancer Patients with Chemotherapy-Induced Anemia Treated with Erythropoietic-Stimulating Agents (ESAs).

Abstract

Background: Clinical trial evidence has demonstrated greater anemia-related fatigue at lower hemoglobin (Hb) levels in ESA-treated patients with chemotherapy-induced anemia (CIA). To understand these patient-reported outcomes (PROs), during ESA treatment in a real-world setting, data were analyzed from the Dosing and Outcomes Study of Erythropoiesis-Stimulating Therapies (D.O.S.E.) Registry, an ongoing, prospective, observational study.Methods: Patients included for analysis were required to have a baseline Hb prior to ESA administration and at least two ESA administrations. PROs were measured using the Functional Assessment of Cancer Therapy: Fatigue subscale (FACT-F), a 13-question measure of anemia-associated fatigue with lower scores indicating greater fatigue in patients with CIA. Patients were to have completed up to three FACT-F questionnaires within seven days of a post-baseline Hb level. If multiple Hb values were identified, the Hb value closest to the FACT-F assessment was reported. The association between FACT-F scores and Hb levels was tested in a repeated-measures analysis. Mean FACT-F scores were calculated for specified Hb ranges.Results: 740 CIA patients from 63 sites were identified between 12/03 and 7/08. 1088 concurrent FACT-F and Hb level assessments were available during ESA treatment. Mean FACT-F scores were lower when patients had lower Hb levels (table). The association between FACT-F scores and Hb levels showed a significant positive trend (p<.0001).Hb≤ 8.0 g/dL8.01–9.0 g/dL9.01–10.0 g/dL10.01–11.0 g/dL11.01–12.0 g/dLn (concurrent FACT-F and Hb assessments)1963212336458Mean FACT-F score (SD)21.26 (11.01)22.95 (12.44)25.64 (12.40)26.84 (11.70)29.34 (12.04)Conclusions: This analysis of FACT-F assessments in CIA patients suggests that lower Hb levels were associated with greater anemia-related fatigue. These findings are consistent with clinical trial evidence and provide observational PRO data to patients and providers regarding anemia-related fatigue during ESA treatment.