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皮下注射 HX575 重组人促红细胞生成素α治疗透析前及透析患者慢性肾脏病相关性贫血的安全性和免疫原性评估

Evaluation of the safety and immunogenicity of subcutaneous HX575 epoetin alfa in the treatment of anemia associated with chronic kidney disease in predialysis and dialysis patients
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作者信息

Casadevall Nicole, Dobronravov Vladimir, Eckardt Kai-Uwe, Ertürk Sehsuvar, Martynyuk Liliya, Schmitt Susanne, Schaffar Gregor, Rudy Anita, Krendyukov Andriy, Ode Marité

出版信息

Clin Nephrol. 2017 Oct;88(10):190-197. doi: 10.5414/CN109159.

Abstract

AIM

To assess the safety and immunogenicity of subcutaneous (SC) HX575 (epoetin-α) in dialysis- and nondialysis-dependent adult patients with chronic kidney disease (CKD).

METHODS

Open-label, single-arm, multicenter study in patients (n = 416) from Germany, Italy, Poland, Romania, Russia, Turkey, and Ukraine.

RESULTS

Mean (standard deviation (SD)) age was 52.3 (15.8) years, all patients were Caucasian, and similar proportions were male/female. 250 patients (60.1%) were erythropoiesis-stimulating agent (ESA)-naïve, and 166 (39.9%) were receiving ESA maintenance therapy at study start; mean (SD) on-study treatment duration with HX575 was 43.4 (15.8) weeks and 45.3 (13.7) weeks, respectively. Binding antierythropoietin (EPO) antibodies were detected by radioimmunoprecipitation (RIP) assay in 7 patients (1.7%; incidence 0.019); 5 of these were ESA-naïve at study entry. No patient developed neutralizing antibodies as determined in a cell-based epoetin neutralizing assay. Of the 7 patients with a positive binding anti-EPO RIP assay, 4 tested negative at later time points while continuing HX575 treatment. Three patients had low titers of anti-EPO antibodies at the last study assessment. There were no clinical signs of immunogenicity or hypersensitivity.

CONCLUSIONS: SC HX575 was effective for correcting and maintaining correction of anemia, and the mean weekly dose remained stable over time.
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摘要

目的

评估皮下注射 HX575(促红细胞生成素-α)在依赖透析和不依赖透析的成年慢性肾脏病(CKD)患者中的安全性和免疫原性。

方法

对来自德国、意大利、波兰、罗马尼亚、俄罗斯、土耳其和乌克兰的患者(n = 416)进行开放标签、单臂、多中心研究。

结果

平均(标准差)年龄为52.3(15.8)岁,所有患者均为白种人,男女比例相似。250例患者(60.1%)既往未使用过促红细胞生成素刺激剂(ESA),166例患者(39.9%)在研究开始时接受ESA维持治疗;使用HX575的平均(标准差)研究治疗持续时间分别为43.4(15.8)周和45.3(13.7)周。通过放射免疫沉淀(RIP)测定法在7例患者(1.7%;发生率0.019)中检测到结合抗促红细胞生成素(EPO)抗体;其中5例在研究入组时未使用ESA。在基于细胞的促红细胞生成素中和试验中,没有患者产生中和抗体。在7例抗EPO RIP测定呈阳性的患者中,4例在继续使用HX575治疗的后期时间点检测为阴性。3例患者在最后一次研究评估时抗EPO抗体滴度较低。没有免疫原性或超敏反应的临床体征。

结论

皮下注射HX575对纠正和维持贫血的纠正有效,且平均每周剂量随时间保持稳定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fef/5607454/2e3d7e526e84/clinnephrol-88-190-01.jpg

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