title: Once-monthly subcutaneous C.E.R.A. maintains stable hemoglobin control in patients with chronic kidney disease on dialysis and converted directly from epoetin one to three times weekly.
abstract: BACKGROUND
  C.E.R.A., a continuous erythropoietin receptor activator, is in development to provide anemia correction and stable maintenance of hemoglobin (Hb) levels at extended administration intervals in patients with chronic kidney disease (CKD). This study examined its efficacy and safety when administered up to once monthly in patients who have CKD and are on dialysis and randomly convert directly from epoetin alpha or beta one to three times weekly.
  
  
  METHODS
  In this three-arm, comparator-controlled, open-label, randomized, parallel-group, Phase III study, 572 dialysis patients (> or =18 yr) who were receiving stable subcutaneous epoetin one to three times weekly were randomly assigned (1:1:1) to continue epoetin or to receive subcutaneous C.E.R.A. once monthly or twice monthly for 52 wk. Dosage was adjusted to maintain Hb +/-1.0 g/dl of baseline level. Primary end point was mean change in Hb level between baseline and the evaluation period (weeks 29 to 36).
  
  
  RESULTS
  Mean Hb levels during the evaluation period were similar between groups (once-monthly C.E.R.A. 11.5 g/dl; twice-monthly C.E.R.A. 11.7 g/dl; epoetin 11.5 g/dl). The difference between C.E.R.A. and epoetin in mean change (97.5% confidence interval) in Hb concentration between baseline and evaluation was -0.022 g/dl (-0.262 to 0.217) for once monthly and 0.141 g/dl (-0.098 to 0.380) for twice monthly. Analysis demonstrated that C.E.R.A. was as effective as epoetin in maintaining Hb and was well tolerated.
  
  
  CONCLUSIONS
  Subcutaneous C.E.R.A. once or twice monthly successfully maintained tight and stable Hb levels in patients who were on dialysis and randomly converted directly from epoetin one to three times weekly.
authors: Clinic of Nephrology Collegium Medicum, Jagiellonian University, Cracow, Poland. wladsul@mp.pl
authors: Wladyslaw
authors: W
authors: Sulowicz
authors: Francesco
authors: F
authors: Locatelli
authors: Jean-Philippe
authors: JP
authors: Ryckelynck
authors: Jozsef
authors: J
authors: Balla
authors: Botond
authors: B
authors: Csiky
authors: Kevin
authors: K
authors: Harris
authors: Patricia
authors: P
authors: Ehrhard
authors: Ulrich
authors: U
authors: Beyer
mesh_terms: D000740:Anemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007279:Injections, Subcutaneous; D007674:Kidney Diseases / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins; D006435:Renal Dialysis
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; C508420:continuous erythropoietin receptor activator; C103998:epoetin beta; D004921:Erythropoietin; D011092:Polyethylene Glycols; D000068817:Epoetin Alfa