Esposito C, Abelli M, Sileno G, Migotto C, Torreggiani M, Serpieri N, Maggi N, Esposito V, Grosjean F, Scaramuzzi M L, Montagna F, Canton A D
Nephrology, Policlinico San Matteo, University of Pavia, Pavia, Italy.
Transplant Proc. 2012 Sep;44(7):1916-7. doi: 10.1016/j.transproceed.2012.05.063.
Erythropoietin-stimulating agents (ESAs) are commonly used to treat anemia in kidney transplant recipients (KTRs). Since 2007, continuous erythropoietin receptor activator (CERA) has been one of the newest recombinant ESAs to treat anemia in dialysis and nondialysis patients with chronic kidney disease. The efficacy of CERA to manage anemia has not been extensively evaluated in KTRs. We evaluated safety, efficacy, and satisfaction among KTRs treated with CERA. We enrolled 19 anemic KTRs (60 ± 9.3 y) who were treated with short-acting ESA for ≥24 weeks. They were shifted to the equivalent dose of CERA and followed for 24 weeks. We measured serum hemoglobin, hematocrit, creatinine, iron, ferritin, and transferrin. To investigate tolerance to and satisfaction with short-acting ESA and CERA, questionnaires were administered to the patients before shifting to CERA and at the end of the follow-up. After 6 months, CERA induced an increase in hemoglobin levels (12.3 ± 0.8 vs 11.2 ± 1.1 g/dL; P = .002, CERA vs short-acting ESA, respectively). In 2 patients treatment was discontinued because the hemoglobin increased to >13 g/dL. No significant differences were observed in serum iron and creatinine between short-acting ESA and CERA throughout the study. The questionnaires showed better compliance to CERA treatment with reduced pain at the injection site, which led subjects to prefer CERA to short-acting ESA. In summary, CERA showed better control of anemia compared with short-acting ESA. It was preferred by the majority of patients, mainly because of the reduced number of monthly injections. Our results demonstrated CERA to be effective, safe, and well tolerated in the management of anemia in KTRs.
促红细胞生成素刺激剂（ESAs）常用于治疗肾移植受者（KTRs）的贫血。自2007年以来，持续促红细胞生成素受体激活剂（CERA）一直是治疗慢性肾脏病透析和非透析患者贫血的最新重组ESAs之一。CERA治疗贫血在KTRs中的疗效尚未得到广泛评估。我们评估了接受CERA治疗的KTRs的安全性、疗效和满意度。我们招募了19名贫血的KTRs（60±9.3岁），他们接受短效ESA治疗≥24周。将他们转换为等效剂量的CERA并随访24周。我们测量了血清血红蛋白、血细胞比容、肌酐、铁、铁蛋白和转铁蛋白。为了调查对短效ESA和CERA的耐受性和满意度，在转换为CERA之前和随访结束时向患者发放问卷。6个月后，CERA使血红蛋白水平升高（分别为12.3±0.8 vs 11.2±1.1 g/dL；P = 0.002，CERA vs短效ESA）。2名患者因血红蛋白升至>13 g/dL而停止治疗。在整个研究过程中，短效ESA和CERA之间的血清铁和肌酐没有观察到显著差异。问卷显示对CERA治疗的依从性更好，注射部位疼痛减轻，这使得受试者更喜欢CERA而不是短效ESA。总之，与短效ESA相比，CERA对贫血的控制更好。大多数患者更喜欢它，主要是因为每月注射次数减少。我们的结果表明CERA在KTRs贫血管理中有效、安全且耐受性良好。
