Kidney Res Clin Pract.  2014 Dec;33(4):210-216. 10.1016/j.krcp.2014.10.001.

A randomized crossover study of single biweekly administration of epoetin-alpha compared with darbepoetin-alpha in chronic kidney disease patients not receiving dialysis

• Na HY
• Lee YK
• Shin SK
• Yang DH
• Cheon W
• Park JH
• Lee JH
• Song JO
• Jo YI

• KMID: 2224263
• DOI: http://doi.org/10.1016/j.krcp.2014.10.001

Abstract

BACKGROUND
Recent evidence demonstrates that high doses of epoetin-alpha (EPO-alpha) can be administrated at extended intervals, despite its relatively short serum half-life. However, no prospective randomized trials on the effects of extended dosing intervals of EPO-alpha compared with darbepoetin-alpha (DA-alpha) have been performed. This study was designed to investigate whether a single biweekly (Q2W) administration of a high dose of EPO-alpha is as effective as DA-alpha for anemia in chronic kidney disease (CKD) patients not receiving dialysis.
METHODS
Sixty non-dialysis CKD patients were equally randomized to either Q2W subcutaneous EPO-alpha (10,000 unit) or DA-alpha (50microg) therapy groups for the first 6 weeks. After a 6-week washout period, the participants of the EPO-alpha and DA-alpha treatment groups switched to the alternate regimen for 6 weeks. The mean hemoglobin (Hb) levels after erythropoiesis stimulating agent (ESA) therapy and percentage change in Hb levels from baseline to the end of the study were analyzed.
RESULTS
The mean Hb levels of postESA therapy increased significantly compared with those of preESA therapy in both ESA regimens. The percentage increase in Hb levels and erythropoietin resistance index did not show a significant difference between the different ESA regimens. No difference was observed between the regimens regarding mean Hb levels after ESA therapy. Additionally, there were no serious adverse effects leading to withdrawal from treatment.
CONCLUSION
Biweekly high doses of EPO-alpha therapy may be equally as effective as Q2W DA-alpha therapy in maintaining target Hb levels in non-dialysis CKD patients.

Keyword

Anemia; Chronic kidney disease; Darbepoetin-alpha; Epoetin-alpha

MeSH Terms

Anemia
Cross-Over Studies*
Dialysis*
Erythropoiesis
Erythropoietin
Half-Life
Humans
Renal Insufficiency, Chronic*
Erythropoietin