De novo weekly and biweekly darbepoetin alfa dosing in pediatric patients with chronic kidney disease

Warady, Bradley A.; Barcia, John; Benador, Nadine; Jankauskienė, Augustina; Olson, Kurt; Podracká, Ľudmila; Shavkin, Aleksey; Srivaths, Poyyapakkam; Wong, Cynthia; Petersen, Jeffrey

doi:10.1007/s00467-017-3758-5

Cited by 7 publications

(7 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Randomization was low risk in one trial [ 28 ]. The other five were unclear risk, with missing details on randomization or concealment [ 29 , 30 ]. Blinding was unclear risk in one study [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…[ 28 ] conducted an open-label non-inferiority trial in 124 children randomized (1:2) to ongoing rHuEPO therapy or DA, with results demonstrating an equivalent mean change in Hb over 28 weeks. The same team performed a prospective, multicentre double-blind randomized controlled trial of 114 ESA-naïve children comparing weekly versus fortnightly titrated dosing [ 29 ]. This showed that the mean time to target Hb of 10–12 g/dL was equivalent (22 days and 24 days, respectively), although a greater proportion of patients on weekly dosing reached the target Hb at 24 weeks (98% versus 84%).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies assessed QoL [ 29 , 34 , 45 ]. Two studies used a non-validated self-designed questionnaire in children on rHuEPO.…”

Section: Resultsmentioning

confidence: 99%

“…Warady et al. [ 29 ] used the Pediatric Quality of Life Inventory (PedsQL) score to assess changes in QoL in their RCT cohort of 114 children starting DA. The authors noted a statistically significant increase in the PedsQL score from baseline to 6 months (QW: 61.1 → 68.1, Q2W: 62.6 → 67.2).…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Bruce

Schulga

Reynolds

2022

Clinical Kidney Journal

View full text Add to dashboard Cite

Background and objectives Erythropoiesis-stimulating agents (ESAs) revolutionised the management of anaemia in chronic kidney disease (CKD) when introduced in the late 1980s. A range of ESA types, preparations and administration modalities now exist, with newer agents requiring less frequent administration. Though systematic reviews and meta-analyses have been published in adults, no systematic review has been conducted investigating ESAs in children. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement for the conduct of systematic reviews was used. All available literature on outcomes relating to ESAs in children with CKD was sought. A search of MEDLINE, CINAHL and EMBASE databases were conducted by two independent reviewers. Inclusion criteria were: published trials in English; children with chronic and end-stage kidney disease; use of any ESA studied against any outcome measure. An assessment of risk of bias was carried out on all included randomised trials using the criteria from the Cochrane handbook for systematic reviews of interventions. Two tables were used for data extraction for randomised and observational studies. Study type, participants, inclusion criteria, case characteristics, follow up duration, ESA type and dosage, interventions and outcomes were extracted by one author. Results Of 965 identified articles, 58 were included covering 54 cohorts. 6 were randomised trials and 48 were observational studies. 38 studies assessed the efficacy of recombinant human erythropoietin (rHuEPO), 11 of darbepoetin (DA), and 3 of continuous erythropoietin receptor activator (CERA), with 6 studies appraising secondary outcome measures exclusively. Recruitment to studies was a consistent challenge. The commonest adverse effect was hypertension, though confounding effects often limited direct correlation. Two large cohort studies demonstrated a higher hazard of death independently associated with high ESA dose. Secondary outcome measures included quality of life measures, growth and nutrition, exercise capacity, injection site pain, cardiovascular function, intelligent quotient (IQ), evoked potentials, and platelet function. Conclusions All ESA preparations and modes of administration were efficacious, with evidence of harm at higher doses. Evidence supports individualising treatments with strong consideration given to alternate treatments in patients who appear resistant to ESA therapy. Further research should focus on randomised trials comparing the efficacy of different preparations, treatment options in apparently ESA resistant cohorts and clarification of meaningful secondary outcomes to consolidate patient-relevant indices.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Three studies assessed QoL [ 29 , 34 , 45 ]. Two studies used a non-validated self-designed questionnaire in children on rHuEPO.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Bruce

Schulga

Reynolds

2022

Clinical Kidney Journal

View full text Add to dashboard Cite

show abstract

“…ESAs may pose logistical challenges given their expense, need for insurance approval in addition to the need for frequent injections, which often make them an unattractive option to pediatric patients and their caregivers. ESAs also require frequent hemoglobin monitoring given the risk of polycythemia and may also be associated with worsening hypertension ( 89 ). More extensive studies are needed to determine the optimal dosing and safety of ESA for the treatment of pediatric PTA.…”

Section: Discussionmentioning

confidence: 99%

Anemia in Pediatric Kidney Transplant Recipients—Etiologies and Management

Kouri

Kizilbash²

2022

Front. Pediatr.

View full text Add to dashboard Cite

Posttransplant anemia (PTA) is a common complication of pediatric kidney transplantation, with a prevalence ranging from 22 to 85%. PTA is categorized as early (within 6 months posttransplant) and late (>6 months posttransplant). Early PTA is typically associated with surgical blood losses and iron deficiency. Late PTA primarily results from graft dysfunction; however, iron deficiency, drug toxicity, and posttransplant inflammation also play a role. PTA is more severe compared with the anemia in glomerular-filtration-rate matched patients with native chronic kidney disease. Treatment of PTA is directed toward the underlying cause. Erythropoiesis stimulating agents (ESA) are effective; however, their use is limited in the transplant setting. Timely diagnosis and treatment of PTA are vital to prevent long-term adverse outcomes in pediatric transplant recipients.

show abstract

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis

Chung

Palmer

Saglimbene

et al. 2023

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

De novo weekly and biweekly darbepoetin alfa dosing in pediatric patients with chronic kidney disease

Abstract: Darbepoetin alfa can be safely administered either QW or Q2W to ESA-naïve pediatric patients with CKD-related anemia to achieve Hb targets of 10.0-12.0 g/dl.

Cited by 7 publications

References 38 publications

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Use of erythropoiesis-stimulating agents in children with chronic kidney disease: a systematic review

Anemia in Pediatric Kidney Transplant Recipients—Etiologies and Management

Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis

Contact Info

Product

Resources

About