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Conversion from Aranesp® to NESP ® in dialysis patients—Exploration of dosing strategies and the feasibility of extending the dosing interval
Author(s) -
Mok Maggie M. Y.,
Kwan Lorraine P. Y.,
Chan Gary C. W.,
Ma Maggie K. M.,
Wang Angela Y. M.,
Yap Desmond Y. H.,
Choy Cindy B. Y.,
Tang Sydney C. W.,
Chan Tak Mao
Publication year - 2021
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13882
Subject(s) - medicine , dosing , surgery , dialysis
Aim Darbepoetin alpha is available as Aranesp® and NESP®, which differ in the inactive component and maximum dose‐strength of prefilled syringes. We conducted an observational cohort study to investigate optimal conversion strategies and the feasibility of extending dosing intervals with higher‐dose preparations in dialysis patients converting from Aranesp® to NESP®. Methods Adult dialysis patients on Aranesp® with stable haemoglobin of 9–12 g/dL were converted to NESP® at the same monthly total dose according to one of three conversion regimens. Group A included patients on ≤80 mcg/month of Aranesp® who converted with dosing regimen unchanged. Group B patients converted to NESP® with extended dosing intervals using higher individual dose preparations. Group C were patients on 100 mcg Aranesp® who converted to NESP® 120 mcg with extended dosing intervals. Patients were observed for 6 months. Results Fifty patients were included. All 24 Group A patients maintained stable haemoglobin. In Group B, 10 patients (50%) maintained stable haemoglobin with extension of dosing interval from 1.04 ± 0.14 to 3.03 ± 1.28 weeks. Factors associated with success in extending dosing interval included a lower prevalence of cardiovascular disease and a higher Kt/V urea in peritoneal dialysis patients. Four patients (80%) in Group C maintained stable haemoglobin after conversion to NESP® 120 mcg with extended dosing interval. The use of NESP® 120 mcg was well tolerated, and was associated with reduced patient‐reported pain score and 38% reduction of drug cost. Conclusion Dialysis patients on Aranesp® can be successfully converted to NESP® and the dosing interval can be extended successfully in a significant proportion of patients, which could reduce discomfort and drug cost.