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CP-052 Chronic kidney disease: Dosage adjustment of epoetin β and darbepoetin α
  1. C Pérez-Diez1,
  2. H Navarro1,
  3. N De la Llama1,
  4. J Pérez-Pérez2,
  5. M Abad-Sazatornil1
  1. 1Universitary Hospital Miguel Servet, Hospital Pharmacy, ZARAGOZA, Spain
  2. 2Universitary Hospital Miguel Servet, Nephrology Department, Zaragoza, Spain

Abstract

Background Erythropoietic agents (EAs) are indicated in anaemia associated with chronic kidney disease (CKD).

Purpose Determination of average dose of epoetin β and darbepoetin α required to achieve haemoglobin (Hb) levels of 10.0–12.5 g/dl in predialysis patients and rate conversion factor between both EAs.

Material and methods Retrospective study. Inclusion: CKD patients who started treatment with EAs between January and December 2012. Follow-up period: 6 months. Data collected: demographics; baseline: 3 and 6 months data analysis; EA dispensed and posology. Data: medical and pharmacotherapeutic history (Farmatools).

Results 81 patients. Median baseline characteristics: 59.3% men; 74 ± 10 years (30–88); stage 3a (24.7%), 3b (5.0%), 4 (57.8%) and 5 (12.5%); Hb 10.13 ± 1.16 g/dl; 63.0% had serum ferritin values >100 µg/l; 40.7% received epoetin β (average weekly dose: 7718.18 ± 6155.72 IU (500–30 000 IU)) and 59.3% darbepoetin α (average weekly dose: 20.55 ± 10.30 μg (5–50 µg)), as decided by the nephrologist. There were no statistically significant differences by type of EA (epoetin group vs. darbepoetin α group (p ≥ 0.05)) in demographics: 69.7% men vs 65.1% and 75.2 ± 8 years vs 72.3 ± 11 years, respectively; in analytical data: Hb 10.3 ± 1 g/dl vs 10.0 ± 1 g/dl and serum ferritin 258.3 ± 302 vs 261.1 ± 247 µg/l. After 3 months of treatment, 53.1% of patients had Hb 10.0–12.5 g/dl. The average weekly doses to achieve the Hb target range were 6875.0 IU of epoetin β and 20.4 µg of darbepoetin α, which represent a relationship between both doses of 337 IU/1 mg. The type of EAs influenced the response because 67.5% of patients who received darbepoetin compared with 29.2% using epoetin β achieved Hb 10.0–12.5 g/dl (p = 0.003). After 6 months of follow-up, 62.7% achieved Hb 10.0–12.5 g/dl. Average weekly dose: 7035.0 IU of epoetin β and 18.70 µg of darbepoetin α, which represent a relationship of 376 IU/1 mg.

Conclusion After 3 and 6 months of treatment with EAs, more than 50% of patients had a response with a dose ratio between epoetin β and darbepoetin α of 300 IU/1 mg.

References and/or Acknowledgements

  1. Ter Arkh 2012;84:48-52

  2. Am J Kidney Dis 2007;50:471-530

References and/or AcknowledgementsNo conflict of interest.

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