title: Dose conversion ratio one year after switching from epoetin alpha to darbepoetin alpha in Japanese hemodialysis patients.
abstract: OBJECTIVE
  Darbepoetin alpha is effective for renal anemia when epoetin is insufficient. We previously reported that the dose conversion ratio from epoetin alpha to darbepoetin alpha was 1:350.5 after 24 weeks of follow-up. This study assessed the conversion ratio in stable Japanese hemodialysis patients after 52 weeks.
  
  
  METHODS
  A total of 104 hemodialysis patients who were stable on intravenous epoetin alpha were switched to intravenous darbepoetin alpha according to the 1:200 rule. Then they were followed for 52 weeks to assess changes of hemoglobin and the darbepoetin alpha dose.
  
  
  RESULTS
  Eighty-five patients completed the study. Their hemoglobin increased very rapidly during the first 8 weeks. The final conversion ratio was 1:286.6 at 52 weeks. Darbepoetin alpha showed similar efficacy in diabetics and non-diabetics. Patients switching from a high epoetin alpha dose (> or =4500 IU/week) had a higher conversion ratio compared with those switching from a low dose (<4500 IU/week).
  
  
  CONCLUSIONS
  The dose conversion ratio of 1:200 was unsuitable and led to a rapid increase of hemoglobin. A conversion ratio of 1:250 to 1:300 should be employed when switching from epoetin alpha to darbepoetin alpha in Japanese patients.
authors.affiliation: Department of Internal Medicine, Hakuai Clinic, Hiroshima, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hirai
authors.forename: Ayumu
authors.initials: A
authors.lastname: Nakashima
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Shiraki
authors.forename: Norihisa
authors.initials: N
authors.lastname: Takasugi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yorioka
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D000068256:Darbepoetin alfa; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D054796:Drug Dosage Calculations; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000097:blood / Q000208:ethnology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa