Toto Robert D, Pichette Vincent, Navarro Jesus, Brenner Robert, Carroll Wendi, Liu Wei, Roger Simon
University of Texas Southwestern Medical Center, Dallas, TX 75390-8856, USA.
Am J Nephrol. 2004 Jul-Aug;24(4):453-60. doi: 10.1159/000080452. Epub 2004 Aug 25.
This multicenter, open-label study determined safety and efficacy of once-every-other-week administration of darbepoetin alfa for anemia of chronic kidney disease in erythropoietin-naive patients not on dialysis.
Participants with hemoglobin levels <11.0 g/dl at baseline were administered darbepoetin alfa at an initial dosage of 0.75 microg/kg once every other week. The dose was titrated to achieve and maintain a hemoglobin response, defined as a hemoglobin range of between 11.0 and 13.0 g/dl for up to 24 weeks. The primary end point was the dose of darbepoetin alfa at initial hemoglobin response.
Six hundred and eight patients were enrolled, and 463 completed the study; 95% (95% confidence interval: 0.93, 0.97) of the patients who completed treatment achieved a hemoglobin response. The mean darbepoetin alfa dose at the time of response was 63.5 +/- (SD) 16.9 microg, and the mean time to hemoglobin response was 5.7 +/- (SD) 4.5 weeks. Oral iron therapy was administered to 60% and intravenous iron to 16% of the participants. Darbepoetin alfa was well tolerated, and adverse events were consistent with those expected in patients with chronic kidney disease.
Darbepoetin alfa administered once every other week is effective and safe for achieving and maintaining target hemoglobin levels in anemic patients with chronic kidney disease.
本多中心、开放标签研究确定了对于未接受透析的初治红细胞生成素缺乏的慢性肾脏病贫血患者,每两周一次给予达贝泊汀α的安全性和有效性。
基线血红蛋白水平<11.0 g/dl的参与者每两周接受一次初始剂量为0.75μg/kg的达贝泊汀α治疗。调整剂量以实现并维持血红蛋白反应,定义为血红蛋白范围在11.0至13.0 g/dl之间,持续长达24周。主要终点是初始血红蛋白反应时达贝泊汀α的剂量。
共纳入608例患者,463例完成研究;95%(95%置信区间:0.93,0.97)完成治疗的患者实现了血红蛋白反应。反应时达贝泊汀α的平均剂量为63.5±(标准差)16.9μg,血红蛋白反应的平均时间为5.7±(标准差)4.5周。60%的参与者接受了口服铁剂治疗,16%接受了静脉铁剂治疗。达贝泊汀α耐受性良好,不良事件与慢性肾脏病患者预期的一致。
每两周一次给予达贝泊汀α对于慢性肾脏病贫血患者实现并维持目标血红蛋白水平是有效且安全的。