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CP-057 Dosage adjustment of epoetin β and darbepoetin α in chronic kidney disease
  1. C Pérez Diez,
  2. H Navarro,
  3. N De la Llama,
  4. J Pérez-Pérez,
  5. I Navarro,
  6. M Abad
  1. Universitary Hospital Miguel Servet, Pharmacy Department, Zaragoza, Spain

Abstract

Background Erythropoietin (EPO) is indicated in the treatment of anaemia associated with chronic kidney disease (CKD).

Purpose To determine the average dose of epoetin β and darbepoetin α required to achieve adequate levels of haemoglobin (Hb) in patients with CKD not yet undergoing dialysis and the rate conversion factor between the two EPOs.

Material and methods Retrospective study. Patients included: stage 3 to 5 CKD who started treatment with EPO between January 2012–December 2012. Follow-up period: 6 months. Hb target range: 10.0 g/dL–12.5 g/dL. Data collected: sex, age, CKD stage; baseline, 3 and 6 months data analysis; type of EPO and posology. Data: medical and pharmacotherapeutic history (Farmatools).

Results 81 patients. Median baseline characteristics: 59.3% men, age 73.8 years (30–88), stage 3 CKD (29.7%), 4 (57.8%) and 5 (12.5%); Hb 10.2 ± 1.2 g/dL; 63.0% had serum ferritin values >100 ng/ml. 40.7% received epoetin β (average weekly dose: 7,718.2 ± 6,155.7 IU) and 59.3% darbepoetin α (average weekly dose: 20.6 ± 10.3 μg). 46.9% (38/81) of patients changed EPO treatment: 71.1% (27/38) dosage. Hb level increased statistically significantly after 3 (1.5 g/dL average increase, p < 0.001) and 6 months of treatment (1.6 g/dL, p < 0.001); haematocrit level also did at 3 (4.8 g/dL, p < 0.001) and 6 months (5.1 g/dL, p < 0.001). After 3 months 53.1% of patients had Hb 10.0–12.5 g/dL. Average weekly dose to achieve Hb target range: 6,875.0 IU of epoetin β and 20.4 μg of darbepoetin α, which represent a relationship between the two doses of EPOs: 337:1.

Conclusion EPO increased Hb and haematocrit baseline levels statistically significantly after 3 and 6 months of treatment. The relationship between the two doses of EPOs to achieve Hb target range (epoetin β: darbepoetin α) found in our study was different from the relationship described in the Summary of Product Characteristics (337:1 vs. 200:1 respectively).

References and/or Acknowledgements

  1. Nefrología 2008;(Suppl 3):63–6

  2. Nefrología 2012;32(2):221–7

References and/or AcknowledgementsNo conflict of interest.

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