Dose conversion ratio one year after switching from epoetin alpha to darbepoetin alpha in Japanese hemodialysis patients.
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.
Hirai
Takayuki
T
Department of Internal Medicine, Hakuai Clinic, Hiroshima, Japan.
Nakashima
Ayumu
A
Shiraki
Nobuaki
N
Takasugi
Norihisa
N
Yorioka
Noriaki
N
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
D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa