Comparison of Once-Biweekly Administration of Epoetin-alpha with Darbepoetin-alpha in Chronic Kidney Disease Patients Not Receiving Dialysis

Kim, So Young; Choi, Hae Jin; Choi, Hye Jin; Lee, Cho ee; Yun, Seon Ung; Park, Jung Hwan; Lee, Jong Ho; Song, Jong Oh; Jo, Young Il

Abstract

PURPOSE
It is very important to correct renal anemia by erythropoiesis stimulating agents (ESA) because anemia is associated with poor outcomes in chronic kidney disease (CKD) patients. We investigated whether once-biweekly (Q2W) treatment with epoetin-alpha (EPO-alpha) is as effective as Q2W darbepoetin-alpha (DA-alpha) in CKD patients who are not on dialysis.
METHODS
Fifteen CKD patients not receiving dialysis with renal anemia (M:F 6:9, age 60.1+/-7.2 years, eGFR-MDRD 15.7+/-6.4 mL/min/1.73m2, DM 46.7%) were enrolled. All patients received Q2W subcutaneous DA-alpha (40 microgram) for 10 weeks. After 6 weeks of wash-out period, patients were switched to Q2W subcutaneous EPO-alpha (10,000 IU) for 10 weeks.
RESULTS
There were no significant differences in baseline parameters, such as hemoglobin (Hb), serum ferritin, and transferrin saturation, between before DA-alpha therapy and before EPO-alpha therapy. Hb levels significantly increased after completion of ESA therapy (DA-alpha, 9.8+/-0.4 vs. 10.4+/-0.6 g/dL, p=0.001; EPO-alpha, 9.6+/-0.7 vs. 10.2+/-0.4 g/dL, p=0.003). After completion of ESA therapy, Hb levels did not reveal significant differences between two groups (p=0.123). Erythropoietin resistance index (8.2+/-1.6 vs. 8.4+/- 1.5 IU/kg weight/g hemoglobin/week, p=0.136) and % increase of Hb (106.7+/-5.5 vs. 106.8+/-6.4%, p=0.776) were not significantly different between DA-alpha therapy and EPO-alpha therapy. There were no significant adverse effects observed during study periods.
CONCLUSION
These findings indicate that Q2W high dose (10,000 IU) of EPO-alpha therapy in CKD patients who are not on dialysis may be effective in maintaining Hb levels as Q2W DA-alpha therapy.