CREATE: new strategies for early anaemia management in renal insufficiency.

The ongoing Cardiovascular risk Reduction by Early Anaemia Treatment with Epoetin beta (CREATE) trial is investigating the effect of early anaemia correction in around 600 patients with moderate anaemia [haemoglobin (Hb) 11.0-12.5 g/dl] and chronic kidney disease (CKD) not yet requiring renal replacement therapy (creatinine clearance 15-35 ml/min). Patients are being randomized to early treatment or late treatment with epoetin beta (NeoRecormon) administered subcutaneously. The early treatment group starts epoetin beta therapy immediately, aiming for a target Hb level of 13-15 g/dl. The late treatment group only starts epoetin beta therapy once the Hb level has declined to below 10.5 g/dl (target Hb level 10.5-11.5 g/dl). The objective of the study is to examine the impact of an early anaemia treatment strategy on cardiovascular risk in this patient population. Preliminary baseline data from patients recruited so far indicate there are no clinically relevant differences between treatment groups in terms of their baseline characteristics. The baseline data also confirm the heavy burden in terms of cardiovascular disease present in these patients. The CREATE trial is anticipated to provide important new data that could have an impact on new strategies for management of patients with moderate anaemia and CKD not yet requiring renal replacement therapy.

RCT Entities:   Population Interventions Outcomes