Relative safety of peginesatide and epoetin alfa

Eric D. Weinhandl, David T. Gilbertson, Allan J. Collins, Robert N. Foley

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Purpose: Peginesatide, a long-acting erythropoiesis-stimulating agent, was recalled in February 2013 following reports of serious and sometimes fatal hypersensitivity reactions in dialysis patients who received a first dose. We assessed the relative risks of mortality and morbidity in peginesatide-treated and matched epoetin alfa-treated patients. Methods: From standardized extracts of paid Medicare claims in 2012 and 2013, we identified dialysis patients treated with peginesatide or epoetin between 1 July 2012 and 28 February 2013. For each peginesatide-treated patient, we identified with propensity score matching two epoetin-treated control patients. Patients were followed for up to 2days after the first peginesatide dose or the referent epoetin dose for death or hospitalization as a result of cardiovascular morbidity or symptoms (composite event), all-cause hospitalization, and emergency room care. Results: We identified 15633 peginesatide-treated patients and 31266 matched epoetin-treated controls. On the day of dose administration, 19 composite events occurred with peginesatide (incidence, 0.12%) and 14 with epoetin (0.04%); the hazard ratio was 2.7 (95% confidence interval, 1.4-5.4). With follow-up for 1 and 2 subsequent days, hazard ratios were 1.6 (1.0-2.4) and 1.5 (1.1-2.0), respectively. Corresponding hazard ratios were larger among hemodialysis patients with neither intravenous antibiotic nor intravenous iron exposure on the day of dose administration. Hazard ratios for all-cause hospitalization and emergency room care exceeded 1 on and after the day of dose administration. Conclusions: Relative to administration of epoetin alfa, first administration of peginesatide in dialysis patients was acutely associated with higher risk of death or hospitalization as a result of cardiovascular morbidity or symptoms. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Original languageEnglish (US)
Pages (from-to)1003-1011
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Issue number10
StatePublished - Oct 1 2014

Bibliographical note

Publisher Copyright:
© 2014 John Wiley & Sons, Ltd.


  • Claims
  • Dialysis
  • Erythropoiesis-stimulating agent
  • Matching
  • Medicare
  • Pharmacoepidemiology


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