Intravenously administered darbepoetin alfa once a week could maintain hemoglobin level more efficiently than once every 2 weeks in patients on hemodialysis.
BACKGROUND
Darbepoetin alfa, which has a much longer half-life than recombinant human erythropoietin, is used to treat renal anemia. However, there are few reports investigating the efficacy of darbepoetin alfa administered every 2 weeks (Q2W).


METHODS
We performed the single-center, prospective, and randomized study in chronic hemodialysis patients. Clinically stable patients on hemodialysis were recruited, and darbepoetin alfa 15-40 microg/week was administered intravenously once a week (QW) to achieve a hemoglobin (Hb) level of 10.5-12.0 g/dl for 8 weeks prior to randomization. The patients were randomly assigned to 2 different dosing frequency groups: once a week (QW) or every 2 weeks (Q2W). We switched to a double dose in the Q2W group. We measured Hb level every 2 weeks and administered darbepoetin alfa to achieve an Hb level of 10.5-11.5 g/dl. The primary endpoints were the weekly dose of darbepoetin alfa administered at week 24.


RESULTS
We assigned 19 and 20 patients into QW and Q2W, respectively. There were no significant differences between the groups in Hb, transferrin saturation, ferritin, and weekly dose of darbepoetin alfa at end of the baseline period. There was no significant difference in Hb level at week 24, at which time the weekly dose requirement and dose per dry body weight were much higher in the Q2W than in the QW group.


CONCLUSIONS
Administration of darbepoetin alfa Q2W could maintain Hb level similarly to to that obtained QW, but we did not confirm efficiency at a higher dose requirement or blood pressure elevation.
Nagaya
Hiroshi
H
Department of Nephrology and Rheumatology, Tosei General Hospital, Seto, Aichi 489-8642, Japan.
Inaguma
Daijo
D
Kitagawa
Akimitsu
A
Murata
Minako
M
Kamimura
Yutaka
Y
Hamaguchi
Kyoko
K
Tatematsu
Miho
M
Suzuki
Sachiyo
S
Kurata
Kei
K
Yuzawa
Yukio
Y
Matsuo
Seiichi
S
D000368:Aged; D000068256:Darbepoetin alfa; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D006454:Hemoglobins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D005293:Ferritins; D007501:Iron