title: Parameters for successful monthly extended dosing of darbepoetin-alpha in patients undergoing hemodialysis.
abstract: OBJECTIVE
  To document the feasibility and report the results of dosing darbepoetin-alpha at extended intervals up to once monthly (QM) in a large dialysis patient population.
  
  
  METHODS
  175 adult patients treated, at 23 Swiss hemodialysis centres, with stable doses of any erythropoiesis-stimulating agent who were switched by their physicians to darbepoetin-alpha treatment at prolonged dosing intervals (every 2 weeks [Q2W] or QM).
  
  
  METHODS
  Multicentre, prospective, observational study. Patients' hemoglobin (Hb) levels and other data were recorded 1 month before conversion (baseline) to an extended darbepoetin-alpha dosing interval, at the time of conversion, and once monthly thereafter up to the evaluation point (maximum of 12 months or until loss to follow-up).
  
  
  RESULTS
  Data for 161 evaluable patients from 23 sites were included in the final analysis. At 1 month prior to conversion, 73% of these patients were receiving darbepoetin-alpha weekly (QW) and 27% of the patients biweekly (Q2W). After a mean follow-up of 9.5 months, 34% received a monthly (QM) dosing regimen, 52% of the patients were receiving darbepoetin-alpha Q2W, and 14% QW. The mean (SD) Hb concentration at baseline was 12.3 +/- 1.2 g/dl, compared to 11.9 +/- 1.2 g/dl at the evaluation point. The corresponding mean weekly darbepoetin-alpha dose was 44.3 +/- 33.4 microg at baseline and 37.7 +/- 30.8 microg at the evaluation point.
  
  
  CONCLUSIONS
  Conversion to extended darbepoetin-alpha dosing intervals of up to QM, with maintenance of initial Hb concentrations, was successful for the majority of stable dialysis patients.
authors.affiliation: Universitätsspital Zürich, Nephrologie, Zürich, Switzerland. johannes.trachsler@waid.zuerich.ch
authors.forename: J
authors.initials: J
authors.lastname: Trachsler
authors.forename: Z
authors.initials: Z
authors.lastname: Glück
authors.forename: M
authors.initials: M
authors.lastname: Dickenmann
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
authors.forename: M
authors.initials: M
authors.lastname: Brünisholz
authors.forename: P-Y
authors.initials: PY
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Burnier
authors.forename: C
authors.initials: C
authors.lastname: Wahl
authors.forename: R P
authors.initials: RP
authors.lastname: Wüthrich
mesh_terms: D000368:Aged; D000465:Algorithms; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D000068256:Darbepoetin alfa; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005240:Feasibility Studies; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D004921:Erythropoietin; D000068256:Darbepoetin alfa