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KMID : 0359920090280050450
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Korean Journal of Nephrology
2009 Volume.28 No. 5 p.450 ~ p.455
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Comparison of Erythropoietic Effect between Epoetin-α and Darbepoetin-α in Hemodialysis Patients: A Randomized Crossover Study
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Lee Ji-Young
Byun Seung-Woon
Yeo Young-Sun
Yang Won-Seok
Park Su-Kil
Park Jung-Sik
Chang Jai-Won
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Abstract
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Purpose:We aim to compare the erythropoietic effects of epoetin-α (EA, 4000 IU SC thrice a week) with those of darbepoetin-α (DA, 60ug IV weekly, conversion rate to EA=200:1).
Methods:Forty one stable hemodialysis patients were enrolled in this randomized crossover study. After a washout period of erythropoietin stimulating agents (ESA), the patients with hemoglobin (Hb) level of ≤11.0 g/dL were randomly assigned to DA or EA and we measured Hb and reticulocyte levels. When Hb reached >11.0 g/dL, we stopped ESA. When Hb level decreased to ≤11.0 g/dL again, we switched to alternative ESA and repeated the rest of the steps.
Results:Thirty six patients (M:F=20:16, age 62±11 years, Kt/V 1.65, nPCR 1.13 g/kg/day) completed the study. No significant differences were observed in baseline parameters between DA and EA during the period of the clinical trial. The rate of Hb level increase (EA 0.29 g/dL/week, DA 0.30 g/dL/week, p=0.76) and decrease (EA 0.45 g/dL/week, DA 0.38 g/dL/week, p=0.14) were not different between two periods. After ESA stopped, the duration of decreased Hb level of ≤11.0 g/dL was not significantly different (4 weeks in EA vs. 3.9 weeks in DA, p=0.86). Erythropoietin resistance index was 10.59 in the EA period. It was not significantly different from 10.97 in DA period (p=0.49). Nine patients (25%) showed a >30% change in EA efficiency relative to DA efficiency.
Conclusion:There was no significant difference in erythropoietic parameters for both EA and DA.
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KEYWORD
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Epoetin alfa, Darbepoetin alfa, Hemodialysis, Anemia
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