CP-057 Dosage adjustment of epoetin β and darbepoetin α in chronic kidney disease

Abstract

BackgroundErythropoietin (EPO) is indicated in the treatment of anaemia associated with chronic kidney disease (CKD).PurposeTo determine the average dose of epoetin β and darbepoetin α required to achieve adequate levels of haemoglobin (Hb) in patients with CKD not yet undergoing dialysis and the rate conversion factor between the two EPOs.Material and methodsRetrospective study. Patients included: stage 3 to 5 CKD who started treatment with EPO between January 2012–December 2012. Follow-up period: 6 months. Hb target range: 10.0 g/dL–12.5 g/dL. Data collected: sex, age, CKD stage; baseline, 3 and 6 months data analysis; type of EPO and posology. Data: medical and pharmacotherapeutic history (Farmatools).Results81 patients. Median baseline characteristics: 59.3% men, age 73.8 years (30–88), stage 3 CKD (29.7%), 4 (57.8%) and 5 (12.5%); Hb 10.2 ± 1.2 g/dL; 63.0% had serum ferritin values >100 ng/ml. 40.7% received epoetin β (average weekly dose: 7,718.2 ± 6,155.7 IU) and 59.3% darbepoetin α (average weekly dose: 20.6 ± 10.3 μg). 46.9% (38/81) of patients changed EPO treatment: 71.1% (27/38) dosage. Hb level increased statistically significantly after 3 (1.5 g/dL average increase, p < 0.001) and 6 months of treatment (1.6 g/dL, p < 0.001); haematocrit level also did at 3 (4.8 g/dL, p < 0.001) and 6 months (5.1 g/dL, p < 0.001). After 3 months 53.1% of patients had Hb 10.0–12.5 g/dL. Average weekly dose to achieve Hb target range: 6,875.0 IU of epoetin β and 20.4 μg of darbepoetin α, which represent a relationship between the two doses of EPOs: 337:1.ConclusionEPO increased Hb and haematocrit baseline levels statistically significantly after 3 and 6 months of treatment. The relationship between the two doses of EPOs to achieve Hb target range (epoetin β: darbepoetin α) found in our study was different from the relationship described in the Summary of Product Characteristics (337:1 vs. 200:1 respectively).References and/or AcknowledgementsNefrología 2008;(Suppl 3):63–6Nefrología 2012;32(2):221–7No conflict of interest.