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KMID : 0869620140310010621
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 1 p.621 ~ p.628
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Evaluation of Initial Conversion Dose of Methoxy Polyethylene Glycol-epoetin-βin Chronic Renal Failure Patients
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Gu Hyun-Jun
Jeong Da-Som
Ahn Hye-Lim
Han Ok-Youn
La Hyen-O
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Abstract
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Erythropoiesis stimulating agents(ESA) correct renal anemia in a chronic kidney disease(CKD). The MIRCERA(Methoxy polyethylene glycol-epoetin-β, PEG-EPO) is ESA with prolonged half-life and less dosing frequency. The manufacturer recommends the PEG-EPO with initial conversion dose of 120 mcg, 200 mcg or 360 mcg once per month on previous ESA dose. But there have been patients with lower initial conversion doses. We evaluate the efficacy of converting previous ESA to PEG-EPO at doses lower than the recommended. We review the electronic medical record data of CKD patients who used PEG-EPO initially in lower conversion dose on previous ESA in Seoul St. Mary’s Hospital between the period of May 23, 2011 and July 22, 2011. The primary outcomes are the changes of average hemoglobin(Hgb), hematocrit(Hct) levels and Hgb response rates before and after the switch from previous ESA to PEG-EPO. As a result the studied atients(n=34) shift between the PEG-EPO 50 mcg(n=4) or 75 mcg(n=30). The average PEG-EPO dose is 83.6±45.0 mcg/month for three months. The average Hgb is 9.67±0.96 mg/dL before and 10.08±1.04 mg/dL after the switch of medication(p=0.024). Hgb response rates(10 - <13 g/dL) increase from 41.2% to 61.8%, but not significantly(p=0.089). Therefore, PEG-EPO can be efficaciously used at lower conversion doses than as prescribed on the information. However, further prospective, randomized controlled studies are necessary in the future.
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KEYWORD
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Methoxy polyethylene glycol-epoetin-β, PEG-EPO, Chronic renal failure, Anemia, Erythropoietin
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