Amgen Warns About Higher Doses of Anemia Drugs


By Susan Heavey

WASHINGTON (Reuters) - Amgen Inc. has added a warning to its anemia
drug, Aranesp, for kidney dialysis and cancer patients after studies
on similar drugs showed higher doses can cause blood clots and death,
the company said a letter released on Friday.


The world's largest biotechnology company said the new warning stems
from studies done outside the United States on two other anemia drugs
-- Eprex, made by Johnson & Johnson unit Ortho Biotech Products L.P.,
and NeoRecormon, made by Roche Holding AG .

The studies revealed major complications, including blood clots and
death, when doctors used anemia drugs to try to boost hemoglobin
levels beyond what was recommended, the letter said.

A U.S. Food and Drug Administration (news - web sites) panel of
outside experts last year called for more study of the risks of the
anemia drugs, including faster tumor growth and more blood clots. Some
researchers had thought elevating hemoglobin might boost the
effectiveness of chemotherapy and radiation to fight cancer.

Amgen spokeswoman Trish Hawkins said the FDA (news - web sites) asked
the company to add the trial information and warning to Aranesp, which
the company is also studying for use in improving cancer treatment
through increased hemoglobin levels.

"At this point, we know we have not observed this in our oncology
trials," Hawkins said of the blood clot problems.

Amgen shares were off 26 cents at $63.63 in afternoon trading on the
Nasdaq.

"An increased incidence of thrombotic events has been observed in
patients treated with erythropoietic agents," the new label reads,
adding that "a randomized controlled study with "another
erythropoietic product" was "associated with a higher rate of fatal
thrombotic events."

Along with Ortho Biotech's drug Procrit, Aranesp is a bioengineered
version of a human protein, erythropoietin, that stimulates production
of red blood cells. The combined sales of the two anemia drugs amount
to several billion dollars a year.

Aranesp is the Amgen's follow up to its earlier anemia drug called Epogen.

Ortho Biotech in August sent physicians a letter similar to that of
Amgen, which the FDA released in December.

Anemia, a lower than normal number of red blood cells, is usually
measured by a decrease in the amount of hemoglobin, a pigment in those
cells that transports oxygen. Normal levels of hemoglobin are 12 to 18
grams per deciliter of blood.

The studies allowed hemoglobin levels to rise above 12, Amgen said.

Amgen, in its letter, said the new warning did not change its current
recommendations on how doctors should use the drug. "Amgen continues
to recommend that the target hemoglobin should not exceed 12 grams per
deciliter," the letter said.

It was dated Jan. 11 and was posted Friday on the FDA's Web site:
http://www.fda.gov/medwatch/SAFETY/2005/Aranesp_dearhcp.pdf.







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