Switching from epoetin alpha to darbepoetin alpha in Japanese hemodialysis patients: dose conversion ratio.
OBJECTIVE
Darbepoetin alpha is an erythropoietic agent with a 3-fold longer elimination half-life than epoetin. The recommended conversion ratio from epoetin to darbepoetin alpha is 1:200 (1 microg of darbepoetin alpha = 200 IU of epoetin), but several observations have suggested that this ratio overestimates the required dose of darbepoetin alpha. This study assessed the actual conversion ratio for stable Japanese hemodialysis patients and investigated whether darbepoetin alpha promotes uniform erythropoiesis.


METHODS
A total of 104 hemodialysis patients who were stable on epoetin alpha therapy at Hakuai Clinic in Japan were switched to intravenous darbepoetin alpha according to the 1:200 rule. They were followed for 24 weeks to assess changes of hemoglobin and the dose of darbepoetin alpha, as well as changes of the reticulocyte count.


RESULTS
One hundred patients completed the 24-week study and the final conversion ratio was 1:350.5. Darbepoetin alpha showed a similar effect in diabetics and nondiabetics. Data on the reticulocyte count demonstrated that darbepoetin alpha had a sustained effect on erythropoiesis.


CONCLUSIONS
Darbepoetin alpha is effective for Japanese dialysis patients at a lower dose than expected.
Hirai
Takayuki
T
Department of Internal Medicine, Hakuai Clinic, Kure-City, Hiroshima, Japan.
Sugiya
Naoko
N
Nakashima
Ayumu
A
Takasugi
Norihisa
N
Yorioka
Noriaki
N
D000368:Aged; D000068256:Darbepoetin alfa; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004920:Erythropoiesis / Q000187:drug effects* / Q000502:physiology; D004921:Erythropoietin / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000379:methods; D017701:Reticulocyte Count / Q000379:methods
D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa