Kamar Nassim, Guitard Joelle, Ribes David, Esposito Laure, Rostaing Lionel
Department of Nephrology, Toulouse University Hospital, France.
Exp Clin Transplant. 2008 Dec;6(4):271-5.
Darbepoetin alfa is used to treat renal anemia; however, little information is available concerning its use during the posttransplant period, especially in HCV-positive patients treated with ribavirin for active hepatitis C.
This study investigated the efficacy and safety of using darbepoetin alfa in this population during a 6-month treatment period. All anemic patients were HCV/RNA-positive, treated with ribavirin, and had impaired renal function. Patients (n=7) who had not been treated previously with recombinant human erythropoietin (rHuEPO) were placed in "group no rHuEPO." Patients previously with recombinant human erythropoietin (n=16; "group rHuEPO") were switched to darbepoetin alfa according to the European summary of product characteristics.
Seventy-three percent of the patients were men. The mean creatinine clearance at baseline was 58.7 -/+ 21.5 mL/min. All patients received an immunosuppressive treatment. Although mean hemoglobin levels remained stable in group no rHuEPO and increased in group rHuEPO, the difference was not statistically significant. Also, the median darbepoetin-alfa-weighted dose in group no rHuEPO increased while it remained stable in group rHuEPO, as did the median daily dosage of ribavirin; however, these differences were not statistically significant. Creatinine levels and creatinine clearance levels remained stable throughout the study. No significant medical events related to the treatment were reported during the study.
Darbepoetin alfa was found to be efficient and well tolerated in correcting renal anemia in transplant recipients treated with ribavirin for active hepatitis C.
达比加群酯用于治疗肾性贫血；然而，关于其在移植后期间的使用信息很少，尤其是在接受利巴韦林治疗活动性丙型肝炎的HCV阳性患者中。
本研究调查了在6个月治疗期内使用达比加群酯治疗该人群的疗效和安全性。所有贫血患者均为HCV/RNA阳性，接受利巴韦林治疗，且肾功能受损。未接受过重组人促红细胞生成素（rHuEPO）治疗的患者（n = 7）被纳入“未使用rHuEPO组”。先前接受过重组人促红细胞生成素治疗的患者（n = 16；“使用rHuEPO组”）根据欧洲产品特征摘要换用达比加群酯。
73%的患者为男性。基线时平均肌酐清除率为58.7±21.5 mL/分钟。所有患者均接受免疫抑制治疗。尽管未使用rHuEPO组的平均血红蛋白水平保持稳定，使用rHuEPO组的平均血红蛋白水平有所升高，但差异无统计学意义。此外，未使用rHuEPO组的达比加群酯加权剂量中位数增加，而使用rHuEPO组保持稳定，利巴韦林的每日剂量中位数也是如此；然而，这些差异无统计学意义。在整个研究过程中，肌酐水平和肌酐清除率水平保持稳定。研究期间未报告与治疗相关的重大医疗事件。
在接受利巴韦林治疗活动性丙型肝炎的移植受者中，发现达比加群酯在纠正肾性贫血方面有效且耐受性良好。
