Hertel Joachim, Locay Harold, Scarlata Debra, Jackson Lynnae, Prathikanti Radha, Audhya Paul
Nephrology Associates, PC, Augusta, GA 30901, USA.
Am J Nephrol. 2006;26(2):149-56. doi: 10.1159/000092852. Epub 2006 Apr 21.
BACKGROUND/AIM: Darbepoetin alfa, an effective treatment for anemia of chronic kidney disease (CKD), can be administered at extended intervals. Simplify the Treatment of Anemia with Aranesp (STAAR), a multicenter, 52-week study, was conducted to assess the efficacy of darbepoetin alfa administered subcutaneously every other week (Q2W) in maintaining hemoglobin (Hb) in CKD patients not receiving dialysis.
This is a subgroup analysis of subjects converted from once-weekly (QW) recombinant human erythropoietin (rHuEPO; US Aranesp package insert) and who received up to 52 weeks of darbepoetin alfa therapy (evaluation period 20-32 weeks). Enrolled subjects had a creatinine clearance < or = 70 ml/min or an estimated glomerular filtration rate < or = 60 ml/min and transferrin saturation > or = 20%. Darbepoetin alfa doses were titrated to maintain Hb levels < or = 12 g/dl. The primary endpoint was mean Hb during evaluation.
There were 524 subjects enrolled in the study who were previously receiving rHuEPO QW. Mean Hb +/- standard deviation was 11.2 +/- 1.27 g/dl at baseline, and the least squares mean +/- SE was 11.4 +/- 0.04 during evaluation. The mean +/- SD Q2W darbepoetin alfa dose was 49.7 +/- 21.9 microg at baseline and 48.9 +/- 35.5 microg at evaluation. Darbepoetin alfa was well tolerated.
Study subjects with CKD receiving QW rHuEPO were effectively converted to Q2W darbepoetin alfa, which was well tolerated. Hb levels were maintained over 52 weeks without a significant change in darbepoetin alfa dose.
背景/目的:达贝泊汀α是治疗慢性肾脏病(CKD)贫血的一种有效药物,给药间隔可延长。开展了一项多中心、为期52周的简化阿法达贝泊汀治疗贫血(STAAR)研究,以评估每2周皮下注射一次达贝泊汀α在未接受透析的CKD患者中维持血红蛋白(Hb)水平的疗效。
这是一项对从每周一次(QW)重组人促红细胞生成素(rHuEPO;美国阿法达贝泊汀药品说明书)转换而来、接受长达52周达贝泊汀α治疗(评估期20 - 32周)的受试者进行的亚组分析。入选受试者的肌酐清除率≤70 ml/分钟或估计肾小球滤过率≤60 ml/分钟且转铁蛋白饱和度≥20%。滴定达贝泊汀α剂量以维持Hb水平≤12 g/dl。主要终点是评估期间的平均Hb水平。
该研究共纳入524名先前接受QW rHuEPO治疗的受试者。基线时平均Hb±标准差为11.2±1.27 g/dl,评估期间最小二乘均值±标准误为11.4±0.04。每2周一次达贝泊汀α的平均剂量在基线时为49.7±21.9微克,评估时为48.9±35.5微克。达贝泊汀α耐受性良好。
接受QW rHuEPO治疗的CKD研究受试者有效地转换为每2周一次达贝泊汀α治疗,且耐受性良好。在52周内维持了Hb水平,达贝泊汀α剂量无显著变化。