Ling B, Walczyk M, Agarwal A, Carroll W, Liu W, Brenner R
Mountain Kidney Associates, 10 McDowell Street, 8801, Asheville, NC 28801, USA.
Clin Nephrol. 2005 May;63(5):327-34. doi: 10.5414/cnp63327.
Darbepoetin alfa is an erythropoiesis-stimulating glycoprotein that functions by the same mechanism as recombinant human erythropoietin (rHuEPO), but has a three-fold longer serum half-life. Reduction in the frequency of darbepoetin alfa administration would be beneficial to patients with renal disease and their healthcare providers. This study evaluated the effect of extending the darbepoetin alfa dosing interval to once monthly in patients with chronic kidney disease (CKD) not receiving dialysis.
This study was a multicenter, open-label study of 97 patients with CKD not on dialysis. Patients receiving stable subcutaneous doses of darbepoetin alfa once every two weeks were converted to darbepoetin alfa once monthly for 29 weeks. The proportion of patients who successfully maintained hemoglobin concentrations between 10.0 and 12.0 g/dl and the mean darbepoetin alfa dose were evaluated. Safety measurements (e.g. adverse events, laboratory parameters, blood pressure) and seroreactivity were assessed.
Hemoglobin concentration was maintained within the target range in 79% (95% confidence interval (CI) = 71% to 87%) of all patients receiving darbepoetin alfa and in 85% (95% Cl = 78% - 93%) of patients who completed the study period. The mean +/- standard deviation monthly darbepoetin alfa dose was similar between baseline (88.7 +/- 49.9 microg) and the evaluation period (86.6 +/- 78.8 microg). The safety profile for monthly darbepoetin alfa administration was comparable with that previously observed with more-frequent administration.
Patients with CKD who are clinically stable on darbepoetin alfa administered once every two weeks can be safely and effectively converted to darbepoetin alfa administered once monthly.
达比加群酯是一种促红细胞生成的糖蛋白,其作用机制与重组人促红细胞生成素(rHuEPO)相同,但血清半衰期长三倍。延长达比加群酯给药频率对肾病患者及其医护人员有益。本研究评估了将达比加群酯给药间隔延长至每月一次对未接受透析的慢性肾脏病(CKD)患者的影响。
本研究是一项针对97例未接受透析的CKD患者的多中心、开放标签研究。接受每两周一次稳定皮下注射达比加群酯的患者改为每月一次,持续29周。评估成功将血红蛋白浓度维持在10.0至12.0 g/dl之间的患者比例以及达比加群酯的平均剂量。评估安全性指标(如不良事件、实验室参数、血压)和血清反应性。
在所有接受达比加群酯的患者中,79%(95%置信区间(CI)=71%至87%)的患者血红蛋白浓度维持在目标范围内,在完成研究期的患者中,这一比例为85%(95% CI = 78% - 93%)。达比加群酯每月平均剂量(平均值±标准差)在基线时(88.7±49.9微克)和评估期(86.6±78.8微克)相似。每月一次达比加群酯给药的安全性与之前更频繁给药时观察到的情况相当。
每两周接受一次达比加群酯治疗且临床稳定的CKD患者可以安全有效地改为每月一次给药。