Khullar Dinesh, Muchhala Snehal S, T Abhishek
Nephrology and Renal Transplant Medicine, Max Super Specialty Hospital, New Delhi, IND.
Medical Affairs, Dr. Reddy's Laboratories, Hyderabad, IND.
Cureus. 2024 Jan 3;16(1):e51613. doi: 10.7759/cureus.51613. eCollection 2024 Jan.
Anemia is a prevalent and debilitating complication in patients with chronic kidney disease (CKD). It presents multifaceted challenges that impact patients' quality of life and overall well-being. The advent of darbepoetin alfa (DPO) as a therapeutic alternative to recombinant human erythropoietin alpha (EPO) has revolutionized the management of CKD-associated anemia. This review article presents a comprehensive comparative analysis highlighting the advantages of DPO over EPO in the effective management of anemia, in both predialysis and dialysis-dependent (DD) CKD patients. DPO's distinct pharmacokinetic advantages play a pivotal role in its efficacy and safety. With a significantly longer half-life and several-fold increased biological activity compared to EPO, DPO enables extended dosing intervals. Through an in-depth examination of diverse clinical trials, it becomes evident that DPO consistently demonstrates remarkable efficacy and safety in improving and maintaining hemoglobin (Hb) levels. Furthermore, its simplified dosage regimen, coupled with the convenience of less frequent administration, not only improves patient adherence but also translates to reduced healthcare costs and resource utilization. In conclusion, this review provides compelling evidence of the advantages of DPO over conventional recombinant human EPO for managing anemia in CKD patients, both in the predialysis and dialysis-dependent CKD patients. DPO's pharmacokinetic advantages, patient-centered advantages, enhanced compliance, and cost-effectiveness converge to establish DPO as a transformative therapeutic option. In both predialysis and dialysis settings, DPO's superior efficacy and patient-centric attributes collectively redefine the landscape of anemia management in CKD.
贫血是慢性肾脏病(CKD)患者中普遍存在且使人衰弱的并发症。它带来了多方面的挑战,影响患者的生活质量和整体健康状况。达贝泊汀α(DPO)作为重组人促红细胞生成素α(EPO)的一种治疗替代药物的出现,彻底改变了CKD相关性贫血的管理方式。这篇综述文章进行了全面的比较分析,突出了DPO在有效管理贫血方面相对于EPO的优势,涵盖了透析前和依赖透析(DD)的CKD患者。DPO独特的药代动力学优势在其疗效和安全性方面发挥着关键作用。与EPO相比,DPO的半衰期显著更长,生物活性提高了数倍,从而能够延长给药间隔。通过对各种临床试验的深入研究,很明显DPO在改善和维持血红蛋白(Hb)水平方面始终表现出显著的疗效和安全性。此外,其简化的给药方案,加上给药频率较低的便利性,不仅提高了患者的依从性,还转化为医疗成本和资源利用的降低。总之,这篇综述提供了令人信服的证据,证明在管理CKD患者贫血方面,DPO相对于传统重组人EPO具有优势,无论是透析前还是依赖透析的CKD患者。DPO的药代动力学优势、以患者为中心的优势、依从性提高以及成本效益共同使DPO成为一种变革性的治疗选择。在透析前和透析环境中,DPO卓越的疗效和以患者为中心的特性共同重新定义了CKD贫血管理的格局。