FDA (Food and Drug Administration)

ESAs stimulate the bone marrow to produce and generate red blood cells. ESAs are given to patients with chronic kidney failure and to patients on chemotherapy. The FDA approved the use of ESAs for the treatment of anemia, which is low red blood cells and low hemoglobin levels in the body.

Recently though, the FDA has decided to require more education for both the patient and physician before prescribing. This is because there is new evidence that ESAs cause shortened overall survival and increased risk. The FDA requires that ESAs be included on the REMS (Risk Evaluation and Mitigation Strategy) list. REMS is a medication guide which describes the risks and benefits of ESAs and must be provided to all patients receiving ESAs.

Initially FDA approval was given in order to reduce the number of blood transfusions these patients would require.

There are three erythropoiesis stimulating agents (ESAs):
- Procrit (epoetin alfa), Epogen (epoetin alfa), or Aranesp (darbepoetin alfa.

According to the FDA, clinical trials demonstrated Avastin did not increase the survival for women with breast cancer. In fact, the overall survival appeared to be shorter in women who took the drug. The reasons for that are not clear, and the possibility remains that some known or unknown side effect of the drug could have contributed to this outcome.