Department of Nephrology, Hospital Clínico San Carlos, Calle del Profesor Martín Lagos, S/N 28040, Madrid, Spain.
Adv Ther. 2012 Nov;29(11):979-91. doi: 10.1007/s12325-012-0063-3. Epub 2012 Nov 13.
Continuous erythropoietin receptor activator (C.E.R.A.) effectively enables anemia control in patients with chronic kidney disease, but little information is available in renal transplant recipients. The authors aimed to evaluate the effect of C.E.R.A. under clinical practice conditions on anemia control in renal transplant recipients.
This was a multicenter, retrospective, observational study carried out in adult renal transplant patients in the immediate posttransplant period and at late posttransplant period receiving C.E.R.A. in clinical practice. Patients' data were retrieved from their medical charts at baseline and months 1, 3, and 6.
A total of 318 evaluable patients were enrolled into the study: 32 in the immediate posttransplant period and 286 at late posttransplant period (erythropoiesis-stimulating agent [ESA]-naïve, n = 44; converting from other ESAs, n = 242). Patients in the immediate posttransplant period experienced a significant increase in hemoglobin (Hb) levels from baseline to month 1 (9.9±1.5 g/dL vs. 11.5±1.4 g/dL; P< 0.001). ESA-naïve patients showed increasing mean Hb levels from baseline to month 6 (10.1±0.7 g/dL vs. 11.7±1.0 g/dL; P < 0.001) and 94.7% achieved Hb ≥11 g/dL during the study. In patients converted from other ESAs, the percentage of patients with Hb between 11-13 g/dL was maintained from baseline to month 6 with no significant differences (61.0% vs. 62.4%). Mean monthly doses of C.E.R.A. at baseline were 134.4±56.4 μg, 81.3±28.1 μg, and 93.0±44.2 μg in immediate posttransplant, ESA-naïve, and converted patients, respectively. C.E.R.A. was well tolerated.
C.E.R.A. enables anemia control in renal transplant recipients, allowing target Hb levels to be achieved and maintained with doses even below those described in the Summary of Product Characteristics.
持续红细胞生成素受体激活剂(C.E.R.A.)可有效控制慢性肾脏病患者的贫血,但在肾移植受者中相关信息较少。作者旨在评估临床实践中 C.E.R.A.在肾移植受者中的应用对贫血控制的影响。
这是一项多中心、回顾性、观察性研究,在肾移植后即刻和晚期接受 C.E.R.A.的临床实践中的成年肾移植患者中进行。从患者的病历中检索基线及 1、3 和 6 个月时的数据。
共有 318 例可评估患者入组本研究:即刻移植期 32 例,晚期移植期 286 例(未使用促红细胞生成素刺激剂[ESA],n=44;转换为其他 ESA,n=242)。即刻移植期患者的血红蛋白(Hb)水平从基线至 1 个月时显著升高(9.9±1.5 g/dL 比 11.5±1.4 g/dL;P<0.001)。未使用 ESA 的患者从基线至 6 个月时 Hb 均值逐渐升高(10.1±0.7 g/dL 比 11.7±1.0 g/dL;P < 0.001),研究期间 94.7%的患者 Hb 达到≥11 g/dL。在从其他 ESA 转换的患者中,Hb 为 11-13 g/dL 的患者比例从基线到 6 个月保持不变,无显著差异(61.0%比 62.4%)。即刻移植、ESA 未使用和转换患者的 C.E.R.A. 月均剂量分别为 134.4±56.4 μg、81.3±28.1 μg 和 93.0±44.2 μg。C.E.R.A. 耐受良好。
C.E.R.A.可使肾移植受者的贫血得到控制,使目标 Hb 水平得以实现并维持,剂量甚至低于产品特性摘要中所述剂量。