Pussell Bruce A, Walker Rowan
Department of Nephrology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
Nephrology (Carlton). 2007 Apr;12(2):120-5. doi: 10.1111/j.1440-1797.2006.00761.x.
To determine whether there is a change in the dose of epoetin alfa when switching from subcutaneous (SC) to intravenous (IV) administration in Australian haemodialysis patients.
Validated data from 2214 haemodialysis patients at 16 Australian hospitals who switched from SC to IV administration of epoetin alfa from January 2002 to September 2003 were extracted from the Renal Anaemia Management database provided by Janssen-Cilag. Of these patients, 806 had dosing data for at least 1 month before switch through to 6 months post switch (6 month cohort).
In the 6 month cohort, the mean dose was 10 776 IU/week (95% CI: 10 235, 11 317) at switch compared with 12 008 IU/week (95% CI: 11 447, 12 569) 6 months post switch, an increase in a dose of 1232 IU/week (95% CI: 868, 1596). The mean haemoglobin levels at switch were 11.55 g/dL (95% CI: 11.45, 11.66) compared with 11.59 g/dL (95% CI: 11.49, 11.68) 6 months after switch. Centre and dosing frequency of epoetin alfa before switch were determinants of increased dose.
Changing from SC to IV administration of epoetin alfa resulted in an 11% increase in mean dose to maintain haemoglobin levels in Australian haemodialysis patients.
确定澳大利亚血液透析患者从皮下注射(SC)促红细胞生成素α转换为静脉注射(IV)时,促红细胞生成素α的剂量是否会发生变化。
从杨森-西拉格公司提供的肾脏贫血管理数据库中提取了2002年1月至2003年9月期间澳大利亚16家医院2214例从皮下注射促红细胞生成素α转换为静脉注射的血液透析患者的有效数据。在这些患者中,806例在转换前至少有1个月至转换后6个月的给药数据(6个月队列)。
在6个月队列中,转换时的平均剂量为每周10776国际单位(95%置信区间:10235,11317),而转换后6个月为每周12008国际单位(95%置信区间:11447,12569),剂量增加了每周1232国际单位(95%置信区间:868,1596)。转换时的平均血红蛋白水平为11.55克/分升(95%置信区间:11.45,11.66),而转换后6个月为11.59克/分升(95%置信区间:11.49,11.68)。转换前促红细胞生成素α的中心和给药频率是剂量增加的决定因素。
在澳大利亚血液透析患者中,从皮下注射促红细胞生成素α转换为静脉注射导致平均剂量增加11%以维持血红蛋白水平。