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Title

Parameters for successful monthly extended dosing of darbepoetin-alpha in patients undergoing hemodialysis

Authors
Trachsler, J.
Glück, Z.
Dickenmann, M.
Gauthier, T.
Brünisholz, M.
Burnier, M.
Wahl, C.
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Published in Clinical Nephrology. 2009, vol. 71, no. 6, p. 697-702
Abstract AIM: To document the feasibility and report the results of dosing darbepoetin-alpha at extended intervals up to once monthly (QM) in a large dialysis patient population. MATERIAL: 175 adult patients treated, at 23 Swiss hemodialysis centres, with stable doses of any erythropoiesis-stimulating agent who were switched by their physicians to darbepoetin-alpha treatment at prolonged dosing intervals (every 2 weeks [Q2W] or QM). METHOD: Multicentre, prospective, observational study. Patients' hemoglobin (Hb) levels and other data were recorded 1 month before conversion (baseline) to an extended darbepoetin-alpha dosing interval, at the time of conversion, and once monthly thereafter up to the evaluation point (maximum of 12 months or until loss to follow-up). RESULTS: Data for 161 evaluable patients from 23 sites were included in the final analysis. At 1 month prior to conversion, 73% of these patients were receiving darbepoetin-alpha weekly (QW) and 27% of the patients biweekly (Q2W). After a mean follow-up of 9.5 months, 34% received a monthly (QM) dosing regimen, 52% of the patients were receiving darbepoetin-alpha Q2W, and 14% QW. The mean (SD) Hb concentration at baseline was 12.3 +/- 1.2 g/dl, compared to 11.9 +/- 1.2 g/dl at the evaluation point. The corresponding mean weekly darbepoetin-alpha dose was 44.3 +/- 33.4 microg at baseline and 37.7 +/- 30.8 microg at the evaluation point. CONCLUSIONS: Conversion to extended darbepoetin-alpha dosing intervals of up to QM, with maintenance of initial Hb concentrations, was successful for the majority of stable dialysis patients.
Keywords AgedAlgorithmsAnemia/blood/etiology/prevention & controlDose-Response Relationship, DrugDrug Administration ScheduleDrug Monitoring/methodsErythropoietin/administration & dosage/analogs & derivativesFeasibility StudiesFemaleHematinics/administration & dosageHemoglobins/analysisHumansKidney Failure, Chronic/blood/complications/therapyMaleMiddle AgedProspective StudiesRenal Dialysis/statistics & numerical dataTreatment Outcome
Identifiers
PMID: 19473639
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Research group Groupe Pierre-Yves Martin (néphrologie) (30)
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TRACHSLER, J. et al. Parameters for successful monthly extended dosing of darbepoetin-alpha in patients undergoing hemodialysis. In: Clinical Nephrology, 2009, vol. 71, n° 6, p. 697-702. https://archive-ouverte.unige.ch/unige:5470

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Deposited on : 2010-03-17

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