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

Clin Nephrol. 2009 Jun;71(6):697-702. doi: 10.5414/cnp71697.

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.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Anemia / blood
  • Anemia / etiology
  • Anemia / prevention & control*
  • Darbepoetin alfa
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Monitoring / methods
  • Erythropoietin / administration & dosage
  • Erythropoietin / analogs & derivatives*
  • Feasibility Studies
  • Female
  • Hematinics / administration & dosage*
  • Hemoglobins / analysis
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Dialysis / statistics & numerical data*
  • Treatment Outcome

Substances

  • Hematinics
  • Hemoglobins
  • Erythropoietin
  • Darbepoetin alfa