Comparison of Erythropoietic Effect between Epoetin-alpha and Darbepoetin-alpha in Hemodialysis Patients: A Randomized Crossover Study.
- Author:
Ji Young LEE
1
;
Seung Woon BYUN
;
Young Sun YEO
;
Won Seok YANG
;
Su Kil PARK
;
Jung Sik PARK
;
Jai Won CHANG
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. jwchang@amc.seoul.kr
- Publication Type:Clinical Trial ; Original Article ; Randomized Controlled Trial
- Keywords:
Epoetin alfa;
Darbepoetin alfa;
Hemodialysis;
Anemia
- MeSH:
Anemia;
Cross-Over Studies;
Erythropoietin;
Hemoglobins;
Humans;
Recombinant Proteins;
Renal Dialysis;
Reticulocytes;
Darbepoetin alfa;
Epoetin Alfa
- From:Korean Journal of Nephrology
2009;28(5):450-455
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We aim to compare the erythropoietic effects of epoetin-alpha (EA, 4000 IU SC thrice a week) with those of darbepoetin-alpha (DA, 60ug IV weekly, conversion rate to EA=200:1). METHODS: Forty one stable hemodialysis patients were enrolled in this randomized crossover study. After a washout period of erythropoietin stimulating agents (ESA), the patients with hemoglobin (Hb) level of < or =11.0 g/dL were randomly assigned to DA or EA and we measured Hb and reticulocyte levels. When Hb reached >11.0 g/dL, we stopped ESA. When Hb level decreased to < or =11.0 g/dL again, we switched to alternative ESA and repeated the rest of the steps. RESULTS: Thirty six patients (M:F=20:16, age 62+/-11 years, Kt/V 1.65, nPCR 1.13 g/kg/day) completed the study. No significant differences were observed in baseline parameters between DA and EA during the period of the clinical trial. The rate of Hb level increase (EA 0.29 g/dL/week, DA 0.30 g/dL/week, p=0.76) and decrease (EA 0.45 g/dL/week, DA 0.38 g/dL/week, p=0.14) were not different between two periods. After ESA stopped, the duration of decreased Hb level of < or =11.0 g/dL was not significantly different (4 weeks in EA vs. 3.9 weeks in DA, p=0.86). Erythropoietin resistance index was 10.59 in the EA period. It was not significantly different from 10.97 in DA period (p=0.49). Nine patients (25%) showed a >30% change in EA efficiency relative to DA efficiency. CONCLUSION: There was no significant difference in erythropoietic parameters for both EA and DA.
