Erythropoiesis-Stimulating Agents in Renal Medicine

Locatelli, Francesco; Vecchio, Lucia Del

doi:10.1634/theoncologist.2011-s3-19

Cited by 27 publications

(21 citation statements)

References 43 publications

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“…Sialic acid carbohydrate content affects serum half-life, with increased sialic acid content resulting in longer half-life. Epoetin alfa and zeta both have 14 sialic acid residues,68 and are short acting drugs with a half-life of 6–8 hours when administered intravenously or 19–24 hours if administered subcutaneously 75. The short half-life allows epoetin zeta to be administered up to three times per week to treat anemia due to CKD 24,76…”

Section: Pharmacologymentioning

confidence: 99%

“…Del Vecchio and Locatelli’s review article examined cardiovascular safety (in particular stroke and hypertension), cancer progression, and immunogenicity associated with using ESA to treat anemia in patients with chronic disease 57. To avoid high ESA dosing, the authors suggest using a conservative and individualized approach based on a risk/benefit evaluation, and targeting intermediate Hb levels 75,86…”

Section: Safetymentioning

confidence: 99%

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Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

Davis–Ajami¹,

Wu²,

Downton³

et al. 2014

BTT

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Epoetin zeta was granted marketing authorization in October 2007 by the European Medicines Agency as a recombinant human erythropoietin erythropoiesis-stimulating agent to treat symptomatic anemia of renal origin in adult and pediatric patients on hemodialysis and adults on peritoneal dialysis, as well as for symptomatic renal anemia in adult patients with renal insufficiency not yet on dialysis. Currently, epoetin zeta can be administered either subcutaneously or intravenously to correct for hemoglobin concentrations ≤10 g/dL (6.2 mmol/L) or with dose adjustment to maintain hemoglobin levels at desired levels not in excess of 12 g/dL (7.5 mmol/L). This review article focuses on epoetin zeta indications in chronic kidney disease, its use in managing anemia of renal origin, and discusses its pharmacology and clinical utility.

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Section: Pharmacologymentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

Davis–Ajami¹,

Wu²,

Downton³

et al. 2014

BTT

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“…The third ESA to receive US Food and Drug Administration (FDA) approval in 2007 was Methoxy polyethylene glycol-epoetin beta (Mircera ® ) which is a continuous erythropoietin receptor activator (CERA) [46]. Epoetin beta is another ESA which is widely used in the European Union for the treatment of anemia of CKD, however it is not currently available in the United States, as it is not FDA approved [47]. Other modalities of treatment for anemia of CKD that are currently in clinical development include hematide and hypoxia inducible factor (HIF).…”

Section: Erythropoiesis-stimulating Agents (Esa)mentioning

confidence: 99%

Anemia and Chronic Kidney Disease: Making Sense of the Recent Trials

Ramanath

Gupta²,

Jain³

et al. 2012

RRCT

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Anemia is a very common complication of chronic kidney disease (CKD). Anemia confers significant risk of cardiovascular disease and contributes to decreased quality of life. Anemia in CKD patients can be multi-factorial, including but not invariably due to the underlying renal insufficiency. Identifying the type of anemia is important in this group of patients and can often be challenging. Diagnosing anemia of renal disease due to erythropoietin (EPO) deficiency is a diagnosis of exclusion. Erythropoiesis stimulating agents (ESA) are the mainstay for the treatment of anemia secondary to CKD. However, over the last four years the use of ESA in the treatment of anemia in CKD patients has undergone a severe interrogation as several trials have reported adverse outcomes with targeting higher hemoglobin (Hb) levels with these agents. Thereby, this review describes the pathophysiology of anemia in CKD patients, diagnosis and the current role of ESA's as it relates to anemia of CKD as well as safety and efficacy of ESA's.

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“…3 There is a direct relationship between the severity of anemia and the decline in renal function. 6 The rhEPO response can be affected by both the dose and the cause of anemia. Erythropoietin is predominantly produced by peritubular cells in the kidney.…”

Section: Introductionmentioning

confidence: 99%

Effect of ethnicity on erythropoietin therapy response for hemodialysis patients: A retrospective study

Al-Khalaf

Al-khalaf

Mustafa

2012

Hemodialysis International

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Anemia is a common feature in chronic kidney disease patients due to deficiency of erythropoietin (EPO). Diseased kidneys are unable to produce EPO, which enhances red blood cell production from the bone marrow. Recombinant human EPO in hemodialysis patients was introduced with perfect outcomes as a hormonal substitutive treatment. Some ethnic minority groups have high prevalence of anemia associated with chronic kidney diseases. The aim of this study is to evaluate the differences between African Caribbeans and Caucasians' EPO therapy response with regard to hemoglobin (Hb), some factors affecting it and some comorbid conditions. A retrospective study for 6 months of 100 patients on hemodialysis was conducted on two ethnic minorities groups; 46 patients were African Caribbean and 54 patients were Caucasian, who received EPO therapy at once or three times weekly dose at the Hanbury Dialysis Unit of Royal London Hospital. There were three types of EPO therapy used: Aranesp, Mircera and Neorecormon. Forty-six patients were African Caribbean and 54 patients were Caucasian. There were 63.4% of patients treated by Aranesp while 13% were given Mircera; 22.8% of the sample used Neorecorman. It was shown that the chosen comorbid conditions had higher percentage in the African Caribbeans than in Caucasians. Diabetic and/or hypertensive patients are almost double the patient numbers. In addition, sickle cell anemia is only present in African Caribbeans. There were 43.5% of African Caribbeans and 81.1% of Caucasians who met the standards of Hb level. There was no significant difference between African Caribbeans and Caucasians regarding parathyroid hormone, c-reactive protein, B12, mean corpuscular volume, ferritin, and folate. In this study, there was a significant difference in the Hb levels between African Caribbean and Caucasian groups. Sixty percent of African Caribbeans had mean Hb less than normal levels. However, they received lower EPO dose than Caucasians. As a result, this may affect the whole treatment and therapy which may lead to anemic complications.

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Erythropoiesis-Stimulating Agents in Renal Medicine

Cited by 27 publications

References 43 publications

Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

Anemia and Chronic Kidney Disease: Making Sense of the Recent Trials

Effect of ethnicity on erythropoietin therapy response for hemodialysis patients: A retrospective study

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