Utilization of darbepoetin alfa and epoetin alfa for chemotherapy-induced anemia.
OBJECTIVE
The patterns of use and effectiveness of therapy with darbepoetin alfa and epoetin alfa for chemotherapy-induced anemia (CIA) in hospital outpatient and community settings were evaluated.


METHODS
Data were collected from medical charts at 65 oncology clinics in hospital outpatient and community settings for consecutive patients who received the first dose of either darbepoetin alfa or epoetin alfa between August 1, 2002, and February 15, 2003, and were to have had 12 weeks of follow-up data.


RESULTS
Data from the charts of 3123 patients were abstracted. Of these patients, 2785 were treated with only one erythropoietic agent (1444 with darbepoetin alfa and 1341 with epoetin alfa) and were included in the analysis. The most common initial dosage of darbepoetin alfa was 200 microg every two weeks (61% of darbepoetin alfa recipients), and the most common initial dosage of epoetin alfa was 40,000 units weekly (72%). With these regimens, the dosage was escalated for 22% of darbepoetin alfa recipients and 23% of epoetin alfa recipients at a median of six weeks after the initial dose. The mean change from baseline in hemoglobin concentration after 12 weeks of therapy was similar for both groups, as was the percent of patients with red-blood-cell transfusions during treatment.


CONCLUSIONS
The most common initial dosage of darbepoetin alfa for CIA was 200 microg every two weeks, and the most common initial dosage of epoetin alfa was 40,000 units weekly. At these dosages, the two agents appear to have similar clinical effectiveness.
Herrington
Jon D
JD
Scott & White Memorial Hospital, Department of Clinical Pharmacy, Temple, TX 76508, USA. jherrington@swmail.sw.org
Davidson
Stephen L
SL
Tomita
Dianne K
DK
Green
Larry
L
Smith
Robert E
RE
Boccia
Ralph V
RV
D000368:Aged; D000740:Anemia / Q000139:chemically induced* / Q000188:drug therapy; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D015331:Cohort Studies; D000068256:Darbepoetin alfa; D003625:Data Collection / Q000379:methods / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D017707:Erythrocyte Transfusion / Q000379:methods / Q000706:statistics & numerical data; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000737:chemistry / Q000187:drug effects; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy; D010045:Outpatients / Q000706:statistics & numerical data; D011994:Recombinant Proteins; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa