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Hemoglobin Maintenance and Dosing Strategies Using Intravenous Continuous Erythropoietin Receptor Activator in J apanese Hemodialysis Patients
Author(s) -
Hirai Takayuki,
Nishizawa Yoshiko,
Nakazono Hiroshi,
Asai Mariko,
Yamashita Hideki,
Sasaki Ayako,
Yamashita Tetsumasa,
Yamashita Kazuomi,
Shigemoto Kenichiro,
Harada Satoru,
Mizuiri Sonoo
Publication year - 2013
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12013
Subject(s) - medicine , erythropoietin , anemia , hemodialysis , erythropoiesis , hemoglobin , dosing , darbepoetin alfa , epoetin alfa , urology , gastroenterology
Methoxy polyethylene glycol‐epoetin beta, a continuous erythropoietin receptor activator ( CERA ), is reported to be effective in managing renal anemia but there is little data about CERA in J apan. This study aimed to ascertain the effects of CERA in Japanese hemodialysis patients and the appropriate starting dose of CERA when switching from other erythropoiesis‐stimulating agents. We switched 61 stable hemodialysis patients to 4‐weekly intravenous CERA , from either epoetin beta ( rHuEPO ) or darbepoetin alpha ( DA ). When determining the initial dose of CERA , we used guidelines recommended by the Japanese supplier for switching from rHuEPO , but for DA we based the CERA dose on E uropean reports, because no J apanese guidelines exist. Fifty‐two patients completed the 28‐week study. Hemoglobin was maintained within the target range (10.0–12.0 g/dL). The required CERA dose decreased over the 28 weeks. The hemoglobin level and CERA dose stabilized faster when switching from DA . CERA showed similar efficacy in diabetic and non‐diabetic patients. The effect of CERA is similar regardless of whether patients switch from low‐ or high‐dose erythropoiesis‐stimulating agents. In conclusion, CERA is effective for Japanese hemodialysis patients at a lower dose than expected.