Agarwal Anil K
The Ohio State University, 395 W 12th Avenue, Columbus, Ohio 43210, USA.
Expert Opin Drug Saf. 2009 Mar;8(2):145-53. doi: 10.1517/14740330902793031.
Anemia of chronic kidney disease due to deficiency of erythropoietin is common and has clinical consequences. Erythropoiesis stimulating agents including darbepoetin alfa (DA) are effective in correcting anemia. DA is generally well tolerated and has side effect profile similar to recombinant human erythropoietin. It has a long half-life permitting infrequent dosing. DA has been tested extensively in preclinical and clinical studies and significant experience has accumulated in clinical practice. Global safety profile of DA must consider recent data indicating worse survival, poor cardiovascular outcomes and thrombotic risks of targeting near normal hemoglobin levels and administering high doses of erythropoiesis stimulating agents. Strategies to achieve and maintain a reasonable, individualized target hemoglobin level with minimal variations in hemoglobin level are needed.
由于促红细胞生成素缺乏所致的慢性肾脏病贫血很常见，且会产生临床后果。包括阿法达贝泊汀（DA）在内的促红细胞生成刺激剂在纠正贫血方面有效。DA一般耐受性良好，其副作用与重组人促红细胞生成素相似。它的半衰期长，允许给药频率低。DA已在临床前和临床研究中得到广泛测试，临床实践中也积累了丰富经验。DA的全球安全性概况必须考虑到近期数据，这些数据表明，将血红蛋白水平靶向接近正常水平并给予高剂量促红细胞生成刺激剂会导致生存率降低、心血管结局不佳和血栓形成风险。需要采取策略来实现并维持合理的、个体化的目标血红蛋白水平，同时使血红蛋白水平的波动最小。
