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Related Experiment Videos

Structured conversion from thrice weekly to weekly erythropoietic regimens using a computerized decision-support

Cae Tolman1, Donald Richardson, Cherry Bartlett

  • 1Department of Renal Medicine, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, United Kingdom.

Journal of the American Society of Nephrology : JASN
|March 25, 2005
PubMed
Summary

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Weekly administration of darbepoetin-alpha (DA) and epoetin-beta (EB) effectively managed anemia in hemodialysis patients. Both agents maintained hemoglobin levels, but significant dose differences were observed over nine months.

Area of Science:

  • Nephrology
  • Hematology
  • Pharmacology

Background:

  • Evolving interest in weekly erythropoietic regimens for anemia management.
  • Limited direct comparative studies on available erythropoiesis-stimulating agents (ESAs).
  • Need to evaluate clinical effectiveness of subcutaneous darbepoetin-alpha (DA) versus epoetin-beta (EB) in hemodialysis patients.

Purpose of the Study:

  • To compare the clinical effectiveness of weekly subcutaneous darbepoetin-alpha (DA) and epoetin-beta (EB).
  • To assess hemoglobin outcomes and dose requirements after converting from thrice-weekly epoetin-beta (EB).

Main Methods:

  • A 9-month, single-center, randomized study involving an unselected hemodialysis population.
  • Anemia management guided by a computerized decision-support system.

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  • Per-protocol and modified intention-to-treat analyses were conducted.

    • Main Results:

    • Both darbepoetin-alpha (DA) and epoetin-beta (EB) adequately maintained hemoglobin outcomes with weekly subcutaneous administration.
    • Significant dose reduction observed for DA (0.59 to 0.46 microg/kg/wk) post-conversion.
    • Significant dose increase observed for EB (107.5 to 133.2 IU/kg/wk) with reduced frequency.
    • Mean EB dose was 44% higher than DA dose at hemoglobin stability.

    Conclusions:

    • Weekly subcutaneous administration of DA and EB is effective for managing anemia in hemodialysis patients.
    • Significant differences in maintenance doses were noted between DA and EB over nine months.
    • A computerized decision-support system facilitated effective anemia management with weekly ESA regimens.