Anaemia can be a debilitating condition that affects the quality of life of people who are often already suffering from other illnesses, such as kidney disease or cancer.

At Roche, we research, develop and provide treatments for anaemia in kidney disease. The aim is to help patients regain the energy to continue to enjoy life.

We have a rich history of medical innovation in this field and a promising future with our focus on personalised healthcare - an approach that specifically takes into account emerging knowledge about the molecular pathology of diseases and of patients’ individual characteristics.


Anaemia – an exhausting condition

Anaemia is a common condition describing someone with an abnormally low red blood cell count.

Healthy oxygen-carrying red blood cells, also known as erythrocytes, are produced by our bone marrow at a rate of 2.5 million cells per second and they live for around 120 days. The production of these red blood cells is driven by a hormone called erythropoietin (EPO) which is produced in the kidneys and the process of red blood cell maturation is called erythropoiesis.

Red blood cells use an iron-rich protein called haemoglobin to bind oxygen and deliver it to the cells and tissues of our bodies. Blood travels to the heart and is pumped into the lungs where it is re-oxygenated. The blood then returns to the heart which sends it around the body through a network of vessels known as the vascular system.

When a person is anaemic, there are too few red blood cells circulating in the bloodstream because they are being lost or destroyed too quickly, produced too slowly or are deformed or defective. As a result, the blood cannot effectively transport the oxygen inhaled from the lungs to the tissues of the body.

The main symptom of anaemia is extreme fatigue. As well as feeling very tired for long periods, patients may notice shortness of breath when climbing stairs or palpitations.


Understanding the causes of anaemia

There are different types of anaemia with different causes. Some people can become anaemic due to a poor diet or loss of blood. The condition can also be the result of an underlying illness such as chronic kidney disease (CKD) or cancer.

Damaged kidneys cannot produce enough of the hormoneerythropoietin, which stimulates red blood cell production in the bone marrow. The process of producing new red blood cells falters and the blood can not deliver enough oxygen to the cells.1

Chronic kidney disease is primarily associated with ageing. The most common cause of CKD is damage caused by other long-term conditions, such as type 2 diabetes and high blood pressure (hypertension).2 Many people with stage three, four and five chronic kidney disease develop anaemia.2

Genetic factors make anaemia more prevalent among people of African and Asian descent. They have high rates of diabetes and high blood pressure, resulting in higher levels of CKD than the general population.2

Anaemia can also affect patients with cancer who are having chemotherapy treatment. A variety of factors are involved, including suppression of the production of red blood cells or a shortened cell life span.

At Roche, our insight into the causes of anaemia is integral to our ambition to develop even more personalised solutions to tackle the disease.


Diagnosing anaemia

Regular blood tests can help catch anaemia early and ensure treatment is provided as soon as possible. Nutritional and macrocytic anaemia can be caused by a deficiency of vitamin B12 or Folate.

People with an illness that puts them at risk of anaemia, such as type 2 diabetes or high blood pressure, or if they are suffering from any of the possible symptoms of anaemia, including extreme tiredness, should speak to their doctor.

Anaemia is diagnosed using a test that measures the level of haemoglobin – the protein in red blood cells that binds oxygen and colours blood red – in the blood. A person is considered to be anaemic if their haemoglobin level is below 11 g/dl.3

Normal levels of haemoglobin are 12–16 grams per decilitre(g/dl) of blood in healthy women and 14–18 g/dl in men.


Treating anaemia

With effective treatment, regular monitoring and good management, anaemia can be successfully corrected.

Patients with renal anaemia can be treated with erythropoiesis-stimulating agents (ESAs) which are injected under the skin or into a vein. These treatments stimulate the bone marrow to produce new blood cells when the patient’s body is not producing enough of the hormone erythropoietin (EPO) to stimulate that production itself.

Roche provides a treatment containing the active ingredient epoetin beta, which is a genetically engineered version of erythropoietin (EPO).

We also developed the first in a new class of medicines which are continuous erythropoietin receptor activators. These biosynthetic forms of erythropoietin work in a different way to traditional EPO and can prolong the activation of red blood cell production, enabling treatment to be given less often.

Among the other treatments for different types of anaemia are supplements for anaemia caused by a deficiency of iron, vitamin B12 or folic acid and emergency blood transfusions for life-threatening anaemia after major blood loss.

Roche’s pharmaceutical teams work with healthcare professionals to make treatment products widely available. Our aim is to ensure that all eligible patients have access to the most appropriate treatment for their anaemia.

The Future

For Roche, the future is personal. Fitting the treatment to the patient is an ambitious goal - but the concept of personalised healthcare is at the heart of our research and development strategy. Through this approach, we aim to use new molecular insights to provide more tailored medicines and enhance the management of anaemia.

Roche has a rich pipeline of new products, with global based development teams managing international and local clinical trials working towards new treatments, including those for anaemia. Over 235,400 people took part in our clinical trials worldwide in 2008, receiving access to the latest therapies.

Ultimately, our goal is to use modern technologies to provide healthcare professionals with even more effective biopharmaceutical treatments based on new insights into how anaemia arises at the molecular level.


  1. UK National Kidney Foundation

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