title: New erythropoiesis-stimulating agents: how innovative are they?
abstract: Recombinant human erythropoietin (rHuEPO) has revolutionized the management of anemia in patients with chronic kidney disease. However, being similar to the naturally occurring molecule, rHuEPO is not a perfect pharmaceutical. Given its relatively short halflife, it requires a relatively frequent administration schedule. Moreover, it can be administered only subcutaneously or intravenously and it is unstable at room temperature, making necessary a strict cold chain. Pharmacological research has focused on the development of new agents in order to circumvent these relative disadvantages. New-generation erythropoietin-stimulating agents containing increased carbohydrate content (i.e. darbepoetin-alpha) or a large water-soluble polyethylene glycol moiety (continuous erythropoiesis receptor activator) are already available or nearly for clinical use and allow less frequent administration schedules than rHuEPO. Hematide, which is a dimeric peptide with chemical structure unrelated to EPO, is undergoing phase III clinical trials. Other possible strategies currently under research include fusion EPO proteins, gene therapy, hypoxia-inducible transcription factor stabilizers, GATA inhibition and hematopoietic cell phosphatase inhibition.
authors.affiliation: Department of Nephrology, Dialysis and Renal Transplant, Ospedale A. Manzoni, Lecco, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Del Vecchio
authors.forename: Francesco
authors.initials: F
authors.lastname: Locatelli
mesh_terms: D000740:Anemia / Q000628:therapy*; D004920:Erythropoiesis; D004921:Erythropoietin / Q000627:therapeutic use; D015316:Genetic Therapy; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008970:Molecular Weight; D011994:Recombinant Proteins
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin