Key words:peritoneal dialysis, renal anemia, darbepoetin alfa, serum albumin 〈Abstract〉 Patients with renal anemia have a narrow target range for hemoglobin levels. In some cases, it is difficult to maintain hemoglobin levels within this target range. To manage the treatment of renal anemia in patients undergoing peritoneal dialysis, we examined the relationship between the weekly average darbepoetin alfa dose and hemoglobin levels. The weekly average darbepoetin alfa dose for 15 weeks before a blood test exhibited the highest correlation with hemoglobin levels. Of 39 patients, 22 exhibited a significant positive correlation among / these parameters(p<0.05). On the other hand, the number of patients with serum albumin levels≦3.0 g/dL was significantly higher in the group that exhibited no correlation as compared to the group that did(p=0.01). Using the weekly average darbepoetin alfa dose over 15 weeks, we can estimate the weekly average dose necessary for maintaining hemoglobin levels within the target range. This study demonstrates that examining the relationship between the weekly average darbepoetin alfa dose and hemoglobin levels is useful for determining the ideal dose of darbepoetin alfa in patients undergoing peritoneal dialysis.
Background: Long-acting injectable formulations for HIV infection have been approved and are now available in Japan. Although not currently recommended as first-line drugs in Japanese or overseas guidelines, use of such formulations may increase, in accordance with patient conditions and preference. We determine the level of satisfaction with current anti-HIV drugs and analyzed the preferences of patients who favor long-acting injectable drugs based on their satisfaction level with the present anti-HIV drugs. Methods: People living with HIV (PLWH) who had received antiretroviral therapy (ART) for at least one month and consented to the study between 1 April and 31 December 2021 were included in a survey conducted using a self-administered questionnaire. The content of the survey included satisfaction with seven items (tablet size, ease and feeling when taking the medicine, color, taste, portability, daily oral therapy, and co-payment) related to the anti-HIV drugs they were taking and their need for future drugs (dosage form, frequency of dosing, long-acting injectable, etc.). In addition, factors related to the need for long-acting injectable medications were analyzed with regard to the relationship with satisfaction with anti-HIV drugs. Results: Overall, 667 patients available for analysis were included in this study. Satisfaction with anti-HIV drugs was highest with regard to "co-payment" and lowest with "daily oral therapy". Regarding the need for long-acting injectable medications, logistic regression analysis indicated that tablet size and daily oral therapy were significant predictors of patient preference for a once-every-eight-weeks intramuscular formulation in terms of their requirement for long-acting injectable medications (tablet size, OR=2.14, 95%CI 1.030-4.430, p=0.042; and daily oral therapy, OR=1.75, 95%CI 1.010-3.030, p=0.044). Conclusions: Patients currently receiving anti-HIV drugs who express dissatisfaction with tablet size and daily oral therapy may prefer a long-acting injectable formulation, taking into consideration patient age, employment status, ART history, frequency of daily dosage and concomitant medications other than ART.
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