Monthly Administration of a Continuous Erythropoietin Receptor Activator Provides Efficient Haemoglobin Control in Non-Dialysis Patients during Routine Clinical Practice

Abstract

Hb levels remained stable during routine use of C.E.R.A. in an unselected population of non-dialysis chronic kidney disease patients with anaemia. C.E.R.A. was administered approximately monthly compared with 3-7 doses per month on previous ESA therapy.

Relationship between anaemia management at haemodialysis initiation and patient prognosis

“…If the decline in Hb concentration at haemodialysis initiation could be prevented with long‐acting ESA, it may be able to influence the incidence of events as well. As epoetin‐ β ‐pegol has been reported to have been successfully used to sustain Hb levels in patients with pre‐haemodialysis CKD, it may be able to assist in avoiding major dips during haemodialysis …”

“…For conventional ESA, it was assumed that Hb levels would be around 8.4 g/dL at the time of haemodialysis. In contrast, since long‐acting ESA became commercially available, its application has expanded to patients with pre‐haemodialysis CKD, achieving particular progress in patient convenience (reduction in frequency of hospital visits) and improving anaemia . To date, there are no reports describing exacerbation of anaemia in this period and corresponding prognosis, influence on complications, and the impact of using long‐acting ESA.…”

Subcutaneous C.E.R.A. for the Treatment of Chronic Renal Anemia in Predialysis Patients

“…Data from two observational studies indicate the efficacy of C.E.R.A. in treatment of CRA among predialysis CKD patients in real life clinical practice with an increase in Hb levels from 10.7±1.4 g/dL to 11.5±1.2 g/dL (21) and an overall increase of 1 g/dL (22) in ESA-naïve patients during 12-month and 9 months of follow up, respectively.…”

“…treatment was reported to achieve a more marked increase in hemoglobin levels in kidney transplant recipients compared with short-acting ESA (14). Therefore, C.E.R.A treatment seems to be effective in all cases of CRA, regardless of the stage of the disease (17,21,22) or modality selected for renal replacement therapy (9,11,14,(18)(19)(20).…”

Efficacy of a Simple Dosage Scheme to Convert From Shorter-acting Erythropoiesis-stimulating Agent to Continuous Erythropoietin Receptor Activator in Kidney Transplantation Patients

“…The introduction of continuous erythropoietin receptor activator (CERA), characterized by a long half-life when administered intravenously or subcutaneously, allows a convenient once-monthly administration, has been shown to provide a smooth increase in Hb levels in anemic naïve chronic kidney disease (CKD) patients with lower risk of overshooting and maintaining stable Hb levels in patients switched from shorter-acting ESA [6,7]. There is limited experience in renal transplantation patients.…”