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Aim: In this study, we investigated the efficacy and safety of conversionof stable hemodialysis patients from the current short-acting r-HuEPO(EPO beta) to the long-acting darbepoetin.Method: The study included 12 months of darbepoetin administration.The mean initial conversion ratio was 350 IU of short acting r-HuEPOto 1 microgram of darbepoetin. We adjusted the dose of darbepoetinto maintain hemoglobin levels between 11-12 g/dL. The study wascarried out on 2 consecutive phases of 12 weeks each. Success withthe extended dosing interval was defined as maintenance of meanhemoglobin >10.0 g/dl during each phase.Result: There were 26 patients who fulfilled the entry criteria.Their mean age was 47.0 ± 17.13 years, and the mean duration onhemodialysis was 55.8 ± 14.0 months. The mean weekly dose increasedfrom 28.75 ± 4.2 μg in the biweekly frequency of dosing to 38.5±3.9μg after switching to the monthly protocol. The hemoglobin levelswere maintained at therapeutic range without statistically significantchange throughout the study; the mean hemoglobin levels was 10.81±.86 g/L at start of the study and 10.86 ± .76 g/L at the end of 6 months.Continuing the darbepoetin in 12 patients for one year disclosed nosignificant change of the conversion ratio of the drug, and the meanof hemoglobin levels remained within the targeted limits.Conclusion: Darbepoetin alpha is effective and safe for the treatmentof anemia in hemodialysis patients even at monthly dose intervalsand for long-term. With the the above mentioned conversion ratioand current prices, darbepoetin seems more expensive than the shortacting erythropoetin beta by 15%, 58 % for the biweekly and monthlydoses respectively. However, the longer dosing intervals are certainlymuch better convenience to patients and care takers in comparisonwith the currently used short acting ESAs.

Monthly Administration of Darbepoetin Alpha in Saudi Hemodialysis Patients: is it a Practical Regimen?