Efficacy of Recombinant Human Erythropoietin Administered Subcutaneously to Capd Patients Once Weekly

Frifelt, J J; Tvedegaard, Erling; Bruun, Kirsten; Steffensen, G.; Cintin, C.; Breddam, Marianne; Dominguez, Helena; Jørgensen, Jørgen D.

doi:10.1177/089686089601600608

Cited by 22 publications

(12 citation statements)

References 14 publications

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“…The agreement of the three data sets indicates the robustness of the results and provides a convincing demonstration of equivalence between once-weekly and three times weekly epoetin b administration frequencies. Furthermore, these data confirm the results of previous studies suggesting the effectiveness of once-weekly epoetin treatment [10][11][12][13][14][15].…”

Section: Statistical Considerationssupporting

confidence: 90%

“…Epoetin administration frequency has attracted a high level of attention in recent years, and numerous small-scale studies have shown comparable efficacy and tolerability of once-weekly vs more frequent administration [10][11][12][13][14]. The results of two large-scale, randomized, controlled trials of once-weekly administration of epoetin b became available recently [15,16].…”

Section: Once-weekly Administration Of Epoetinmentioning

confidence: 99%

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A rationale for an individualized administration frequency of epoetin : a pharmacological perspective

Locatelli

Baldamus

Villa

et al. 2002

Nephrology Dialysis Transplantation

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Several studies have compared the efficacy of once-weekly subcutaneous (s.c.) epoetin treatment with two or three times weekly treatment in renal anaemia. Epoetin administration frequency has attracted a high level of attention in recent years, and numerous small-scale studies have shown comparable efficacy and tolerability of once-weekly vs more frequent administration. The results of two large-scale, randomized, controlled trials of once-weekly administration of epoetin beta became available recently. One of these studies, by Locatelli et al., was the first to be designed specifically to demonstrate therapeutic equivalence between once-weekly and three times weekly epoetin beta treatment, using rigorous statistical methods. This was a large, multicentre, randomized, parallel group, 24-week study in 173 chronic renal failure patients. Treatment regimens were considered equivalent if: (i) the 90% confidence interval (CI) of the difference between treatment groups was within +/-2% for the time-adjusted area under the haematocrit (Hct) curve (AUC); and (ii) for mean weekly epoetin beta dose, the 90% CI of the ratio of the groups was between 0.8 and 1.25. As recommended by current guidelines for statistical analysis of clinical trial data, multiple analysis populations were examined in order to demonstrate robustness of the results with regard to the population chosen for analysis. Findings from the primary analysis, the per-protocol population, were confirmed by both the intent-to-treat analysis and an exploratory analysis that examined the influence of five patients who received dose increases above the mean. In all three analyses, the 90% CIs were within the pre-specified equivalence ranges for both the difference between treatment groups for Hct AUC and the ratio of mean weekly epoetin beta dose. In conclusion, once-weekly and three times weekly s.c. epoetin beta treatment regimens are statistically equivalent in terms of maintaining stable Hct levels and dose requirements in haemodialysis patients. The agreement of the three analysis populations provides a convincing demonstration of the robustness of the results. These results confirm that a once-weekly epoetin beta regimen is an effective option for management of renal anaemia that may improve patient convenience and compliance.

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Section: Statistical Considerationssupporting

confidence: 90%

Section: Once-weekly Administration Of Epoetinmentioning

confidence: 99%

A rationale for an individualized administration frequency of epoetin : a pharmacological perspective

Locatelli

Baldamus

Villa

et al. 2002

Nephrology Dialysis Transplantation

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“…Several studies showed that a low Kt/V index indicates anemia, which necessitates higher EPO dose to maintain target plasma hemoglobin levels (18,19). However, some studies found no association between them (12). Our data showed no significant relationship between these variables, as well.…”

Section: Discussioncontrasting

confidence: 62%

“…This leads to lower percentage of anemia in patients on PD in comparison with HD (11). In addition, treatment response to anemia is better in patients treated with PD compared to patients with HD (12). The production of EPO by peritoneal macrophages (6) and losing a little blood during dialysis procedure then in HD are some interacted factors.…”

Section: Introductionmentioning

confidence: 99%

The relationship between anemia and Kt/V index in patients undergoing continuous ambulatory peritoneal dialysis and hemodialysis

Hasanzamani

Sabbagh

2019

J Renal Inj Prev

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Introduction: Anemia in end-stage renal disease (ESRD) can cause serious problems for patients. Objectives: The present study was conducted to investigate whether the type or adequacy of dialysis can affect the incidence of anemia in these patients. Patients and Methods: This cross-sectional study was conducted on 57 patients with ESRD, who were referred to Qaem and Imam Reza hospitals, Mashhad, Iran. The patients were divided into two groups of continuous ambulatory peritoneal dialysis (CAPD) (n=37 patients) and hemodialysis (n=20 patients). Patients had no laboratory evidence of iron deficiency or hyperparathyroidism. Enrolled patients were received vitamin B12 and folic acid too. Hemoglobin concentration of under 11 mg/dL was considered as anemia. Adequacy of dialysis was evaluated by Kt/V index (>1.2 for hemodialysis and >1.7 per week for peritoneal dialysis). We compared different factors in these two groups, including anemia and Kt/V, and evaluated their relationship. Results: Around 27% and 65% of the patients on CAPD and hemodialysis were anemic respectively (P=0.005). Adequacy of dialysis in CAPD was acceptable in 81.1% of the cases, while target Kt/V was achieved in 50% of the patients on hemodialysis. Dialysis adequacy was significantly higher in patients receiving CAPD (P=0.014). No significant correlation between the incidence of anemia and Kt/V in both types of dialysis was found (P>0.05). Conclusion: Anemia was mostly observed in patients receiving hemodialysis as compared to CAPD. Regardless of the type of dialysis, adequacy of dialysis did not affect the incidence of anemia in any of the groups.

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“…Frifelt et al 11 prospectively compared the maintenance dosage requirement of a once weekly SC regimen with a thrice weekly regimen in anaemic patients on continuous ambulatory peritoneal dialysis. All patients were treated with SC EPO three times a week until the haemoglobin stabilized at 10–12 gm/dL for 3 months before being randomized into the study.…”

Section: Discussionmentioning

confidence: 99%

Dosage requirement of erythropoietin can be reduced with more frequent administration

Wang

Lai

et al. 2000

Nephrology

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SUMMARY: In short‐term studies, once weekly and twice weekly dosing regimens of erythropoietin (EPO) have both been shown to be effective in correcting anaemia in dialysis patients. However, the optimal dosing frequency has yet to be determined. The long‐term effects of EPO given by more frequent divided doses in 10 stable haemodialysis patients were studied. The patients achieved a stable haemoglobin level for at least 3 months prior to the study. The frequency of administration was altered from 4000 units once weekly to 2000 units twice weekly in seven patients, from 4000 units once every 10 days to 2000 units twice weekly alternating with 2000 units once weekly in two patients, and from 4000 units fortnightly to 2000 units once weekly in one patient. After the conversion, EPO dosage was adjusted in order to maintain the haemoglobin at the preconversion level. At the end of 28 weeks, the mean haemoglobin level remained unchanged. However, the mean dosage requirement of EPO reduced from 3400 units per week to 2500 units per week (P = 0.019). This represents a significant 26% reduction in dosage and cost. It was concluded that subcutaneous administration of frequent small doses of EPO is a more cost‐effective way of correcting anaemia in haemodialysis patients.

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Efficacy of Recombinant Human Erythropoietin Administered Subcutaneously to Capd Patients Once Weekly

Cited by 22 publications

References 14 publications

A rationale for an individualized administration frequency of epoetin : a pharmacological perspective

A rationale for an individualized administration frequency of epoetin : a pharmacological perspective

The relationship between anemia and Kt/V index in patients undergoing continuous ambulatory peritoneal dialysis and hemodialysis

Dosage requirement of erythropoietin can be reduced with more frequent administration

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