CP-052 Chronic kidney disease: Dosage adjustment of epoetin β and darbepoetin α

Abstract

BackgroundErythropoietic agents (EAs) are indicated in anaemia associated with chronic kidney disease (CKD).PurposeDetermination 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 methodsRetrospective 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).Results81 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.ConclusionAfter 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 AcknowledgementsTer Arkh 2012;84:48-52Am J Kidney Dis 2007;50:471-530No conflict of interest.