Preservation of Anemia Control and Weekly ESA Dosage After Conversion from PEG-Epoetin Beta to Darbepoetin Alfa in Adult Hemodialysis Patients: The TRANSFORM Study

Abstract

IntroductionThere is scant real-world information on switching treatment for anemia associated with chronic kidney disease (CKD) from methoxy polyethylene glycol-epoetin beta (PEG-Epo) to darbepoetin alfa (DA). TRANSFORM was a multi-center, observational study designed to describe the time course of hemoglobin (Hb) concentration (primary outcome measure) and other parameters of clinical management of anemia in European hemodialysis patients in clinical practice before and after a switch from PEG-Epo to DA.MethodsEligible subjects were adult patients with CKD dialyzed at European dialysis centers for ≥26 weeks and treated with PEG-Epo for ≥14 weeks immediately prior to being switched to DA and no earlier than January 2011. Erythropoiesis-stimulating agent doses and Hb values were recorded for the 14-week pre-switch and 26-week post-switch periods.ResultsOf the 1,027 eligible patients enrolled at 42 hemodialysis centers in 7 European countries, 785 were included in analyses. Mean (95% confidence interval [CI]) Hb was generally stable: 11.19 (11.11, 11.26), 11.48 (11.40, 11.57), and 11.29 (11.20, 11.37) g/dL at month −1 pre-switch and months 3 and 6 post-switch, respectively. The geometric mean (95% CI) PEG-Epo dose at month −1 was 27.4 (26.0, 28.8) µg/week; DA dose was 29.4 (27.9, 30.9), 23.3 (21.9, 24.9), and 25.6 (24.1, 27.1) µg/week at months 1, 4, and 6, respectively. The geometric mean (95% CI) dose ratio at switching was 1.06 (1.01, 1.11). When stratifying by dose-ratio categories <0.8, 0.8–1.2, and >1.2 at switching, mean DA dose and Hb converged within narrow ranges by month 6 post-switch: 23.9–27.0 µg/week and 11.1–11.5 g/dL, respectively. Hb excursions <10 g/dL were less frequent post-switch versus pre-switch.ConclusionMean Hb values remained within a narrow range following switching from PEG-Epo to DA in this population of hemodialysis patients. Time trends of mean Hb and DA dose indicate that physicians titrated DA doses post-switch, to attain Hb concentrations comparable to those attained pre-switch with PEG-Epo.FundingAmgen (Europe) GmbH, Zug, Switzerland.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-014-0161-5) contains supplementary material, which is available to authorized users.

Serum Intact and Total Fibroblast Growth Factor 23 Levels and Iron-related Parameters in Hemodialysis Patients

“…Three kinds of ESAs, including epoetin beta, darbepoetin alfa, and epoetin beta pegol, were administered to 57 patients. In this study, based on guidelines [28] and prior research [29,30], the conversion ratio of each ESA dosage was epoetin beta (unit/w): darbepoetin alfa (μg/w)=1:200 and darbepoetin alfa (μg/w): epoetin beta pegol (μg/w)=1:1.2. The weekly doses of darbepoetin alfa and epoetin beta pegol were converted into epoetin β (unit/w) units using the following conversion ratio: ESA dosage conversion ratio; epoetin β (unit/w): darbepoetin alfa (μg/w): epoetin beta pegol (μg/w)=1: 200: 240…”

Cost-Minimization Analysis of Using Short and Long-Acting Erythropoesis-Stimulating Agents for Correction of Nephrogenic Anemia Against the Background of Substitution Therapy

“…Был проведен анализ ряда исследований [5, [12][13][14][15]17], посвященных расчету коэффициентов конвертации доз ЭПО в эквивалентные. Полученные результаты (табл.…”