Practical  guidelnes for the use of NESP in treating renal anaemia

Aljama, Pedro; Bommer, Jürgen; Canaud, Bernard; Carrera, Fernando; Eckardt, Kai‐Uwe; Hörl, Walter H.; Krediet, Raymond T.; Locatelli, Francesco; Macdougall, Iain C.; Wíkström, Björn

doi:10.1093/ndt/16.suppl_3.22

Cited by 60 publications

(44 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study of renal disease patients with anemia, injection site pain was found to be even more common with darbepoetin α than epoetin α given by the s.c. route [43]. This finding was confirmed in an integrated safety database for darbepoetin α including 1,500 renal disease patients treated for up to 24 months [31]. …”

Section: Tolerability Of Once-weekly Epoetin Regimensmentioning

confidence: 79%

“…It has been proposed that therapeutically equivalent doses of epoetin and darbepoetin can be determined by using a ratio (based on equivalent peptide mass) of 200 IU epoetin to 1 µg darbepoetin [31]. Using this ratio, the darbepoetin doses used in phase III trials (2.25–4.5 µg/kg) correspond to weekly doses of 450–900 IU/kg of epoetin or approximately 30,000–60,000 IU epoetin, assuming a 67 kg patient.…”

Section: Once-weekly Treatment Regimensmentioning

confidence: 99%

See 1 more Smart Citation

Once-Weekly Treatment of Anemia in Patients with Cancer: A Comparative Review of Epoetins

Pujade-Lauraine

Topham²

2005

Oncology

View full text Add to dashboard Cite

Anemia is common in cancer patients, but its impact is often poorly appreciated. As well as the negative effect of anemia on the quality of life, there is strong evidence that it is associated with poor treatment outcome and reduced survival. The introduction of recombinant human erythropoietin (epoetin) has provided an effective treatment of anemia, without the risk associated with blood transfusion. A recent randomized study of patients with hematological malignancies showed that once-weekly epoetin β has comparable efficacy at the same overall weekly dose as three-times-weekly treatment. This once-weekly regimen of epoetin β (NeoRecormon^®) has been approved by European Regulatory Authorities for patients with lymphoproliferative malignancies and relative erythropoietin deficiency, who are receiving anti-tumor therapy. Darbepoetin α (Aranesp^®) has also recently been approved for once-weekly treatment of anemia in patients with nonmyeloid malignancies receiving chemotherapy. The improved convenience and reduced administration costs associated with a once-weekly treatment may result in more patients receiving the benefits of epoetin therapy.

show abstract

Section: Tolerability Of Once-weekly Epoetin Regimensmentioning

confidence: 79%

Section: Once-weekly Treatment Regimensmentioning

confidence: 99%

Once-Weekly Treatment of Anemia in Patients with Cancer: A Comparative Review of Epoetins

Pujade-Lauraine

Topham²

2005

Oncology

View full text Add to dashboard Cite

show abstract

“…All ESA doses were converted into IU/kg/week. The conversion factor for darbepoetin alpha was 200 UI of epoetin per 1 μg of darbepoetin [14] .…”

Section: Methodsmentioning

confidence: 99%

Total Convection Affects Serum β2 Microglobulin and C-Reactive Protein but Not Erythropoietin Requirement following Post-Dilutional Hemodiafiltration

et al. 2015

View full text Add to dashboard Cite

Background: Inflammation and increased erythropoiesis stimulating agents (ESA) requirement are frequently associated in patients on dialysis. On-line hemodiafiltration (ol-HDF), putting together high levels of diffusion, and convection could improve both conditions. However, it is still not known which depurative component plays a major role in determining this result. The aim of the study was to evaluate the role of convection and diffusion on long-term variations of serum β₂ microglobulin (Δβ₂M), high-sensitive C-reactive protein (ΔhsCRP) concentrations, and ESA requirement (ΔESA) in ol-HDF. Methods: Seventy-three patients prevalent on high flux HD (hfHD) were studied. Thirty-eight patients were switched from hfHD to post-dilutional ol-HDF (Study group); the other 35 patients were considered the Control group. At 6 and 12 months, the effects of ol-HDF and hfHD on ΔhsCRP, ΔB₂M, and ΔESA (U/kg/week) were evaluated. Other variables considered were body weight (BW), serum albumin (sAlb), hemoglobin (Hb), and equilibrated Kt/V (eKt/V). Iron therapy and ESA were administered intravenously according to the K/DOQI guidelines in order to maintain transferrin saturation between 20 and 40%, serum ferritin between 150 and 500 ng/ml and Hb between 11 and 12 g/dl. Qb, treatment time and Qd remained constant. Ol-HDF and hfHD were performed using membranes of size 1.9-2.1 sqm. Ultrapure dialysate and substitution fluid were employed in both HDF and HD treatments. Data are expressed as mean ± SD. Paired t test, Mann-Whitney U test, and simple and multiple regression analyses were employed for statistical evaluation. Results: Study group: total convective volume (TCV) was 22.1 ± 1.9 l/session. A significant reduction of hsCRP: from 6.8 ± 7.1 to 2.3 ± 2.4 mg/dl (p < 0.001), β₂M: from 36.5 ± 14.4 to 24.7 ± 8.6 mg/dl (p < 0.0001) and ESAdose: from 107 ± 67 to 65 ± 44 U/kg/week (p < 0.005) was observed. No significant variations of Hb, BW and sAlb were seen. A significant inverse correlation was found between TCV and Δβ₂M (r = -0.627; p < 0.0001), and TCV and ΔhsCRP (r = -0.514; p < 0.0001); no correlation between TCV and ΔESAdose was observed. No correlation was found between eKt/V and Δβ₂M, ΔhsCRP, and ΔESAdose. Multiple regression analysis with ΔESAdose as dependent variable showed ΔhsCRP as the only significantly associated independent factor (p < 0.01). Control group: no significant variations of hsCRP, β₂M, and ESAdose were observed over time. Conclusions: Ol-HDF induces a long-term significant reduction in pre-dialysis β₂M and hsCRP concentrations. The magnitude of reduction is directly correlated to the amount of TCV achieved but not on eKt/V. The observed reduction in ESAdose requirement is independent either on convection or diffusion, but is directly associated to the concomitant reduction of inflammation.

show abstract

“…The outcome of interest was the weekly ESA dose expressed in international units/kilogram/week (IU/kg/week). DA doses were converted to conventional rHuEpo units in a ratio of 200 IU rHuEpo:1 µg DA, as the peptide mass of the two preparations are equivalent at this point [9]. In addition, the two agents were cost neutral at this ratio in Portugal and the European Union [10].…”

Section: Methodsmentioning

confidence: 99%

Dose Requirements among Hemodialysis Patients Treated with Darbepoetin-α or Epoetin-β

Prata¹,

Santos²,

Hegbrant³

et al. 2007

Nephron Clin Pract

View full text Add to dashboard Cite

Background/Aims: In a cohort of hemodialysis patients, we evaluated the hypothesis that weekly administration of intravenous (IV) darbepoetin-α (DA) was associated with lower total erythropoiesis-stimulating agent (ESA) requirements as compared to a regimen of multiple subcutaneous (SC) doses per week of epoetin-β (EB). Methods: We studied 1,159 hemodialysis patients who were treated exclusively with either IV DA or SC EB across a network of Portuguese clinics during 2004. Linear regression was used to assess the adjusted relationship between the ESA regimen and weekly ESA requirements over the period of observation. Generalized estimating equations were applied in order to model the population average effects of the correlated mean weekly ESA dose for each individual. We also calculated propensity scores for the receipt of DA and assessed the relationship between ESA type and dose requirement within each quintile of the score. Results: The adjusted dose of IV DA, when expressed as a proportion of the dose used in EB-treated patients, did not differ from the dose administered to EB recipients (0.961, 95% CI 0.904, 1.021). A similar relationship was observed within each propensity score quintile. Conclusions: Hemodialysis patients who received IV DA had dose requirements that were similar to their counterparts who were treated with SC EB. A once-weekly dosing regimen and avoidance of SC administration enhance the attractiveness of DA as an alternative to traditional ESAs. The potential for unmeasured confounding, restriction to a population that was treated with a single ESA preparation and application of a 200 IU:1 µg EB:DA dose conversion are important limitations of this study.

show abstract

Practical guidelnes for the use of NESP in treating renal anaemia

Cited by 60 publications

References 0 publications

Once-Weekly Treatment of Anemia in Patients with Cancer: A Comparative Review of Epoetins

Once-Weekly Treatment of Anemia in Patients with Cancer: A Comparative Review of Epoetins

Total Convection Affects Serum β2 Microglobulin and C-Reactive Protein but Not Erythropoietin Requirement following Post-Dilutional Hemodiafiltration

Dose Requirements among Hemodialysis Patients Treated with Darbepoetin-α or Epoetin-β

Contact Info

Product

Resources

About