title: C.E.R.A. maintains stable hemoglobin in Latin American patients on dialysis.
abstract: BACKGROUND
  C.E.R.A. is a continuous erythropoietin receptor activator with characteristics that permit a once-monthly schedule of administration for the maintenance treatment for chronic kidney disease (CKD) patients. The main objective of this study was to assess the maintenance of Hb concentration with once-monthly intravenous and/or subcutaneous C.E.R.A. therapy in Latin American dialysis patients with chronic renal anemia previously treated with epoetin alfa s.c or i.v 1-3 times per week.
  
  
  METHODS
  This was a single-arm, open-label, multicenter, 32-week study of anemic patients with CKD previously treated with epoetin alfa sc or iv 1-3 times per week. After a 4-week screening period, during which mean Hb levels were maintained between 10.5 and 12.5 g/dL on their previous erythropoiesis stimulating agent, eligible patients entered a 16-week C.E.R.A. dose titration period followed by a 4-week efficacy evaluation period (EEP) and a 28-week safety follow-up. The starting dose of C.E.R.A. was based on the previous dose of epoetin alfa. Doses of C.E.R.A. were then adjusted to maintain Hb levels within ±1.0 g/dL of the reference concentration and between 10.5 and 12.5 g/dL. The Hb reference concentration was defined as the mean of all Hb levels during screening. The primary end point was the proportion of patients maintaining a mean Hb concentration (g/dL) within ±1 g/dL of their reference Hb and between 10.5 and 12.5 g/dL during the EEP.
  
  
  RESULTS
  A total of 163 patients from 27 centers in Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay, and Venezuela entered the treatment period and 102 completed the prescribed course of C.E.R.A. Forty-five patients (43.7 %) maintained a mean Hb concentration within ±1 g/dL of their reference Hb value and between 10.5 and 12.5 g/dL during the EEP. The median monthly dose remained constant at 120 μg during the titration period and during the EEP. On the average, there were only 2.3 dose changes per patient in 28 weeks of treatment, covering 7 C.E.R.A. scheduled administrations. 53 % of all dose changes were dose decreases, 47 % increases. A total of 10 AEs and 4 SAEs were considered to be related to the study treatment.
  
  
  CONCLUSIONS
  Once-monthly C.E.R.A. treatment effectively maintains stable Hb concentrations in patients with chronic renal anemia undergoing dialysis with a good safety and tolerability profile.
authors.affiliation: CLINESE-Centro de Nefrologia de Sergipe, Brazil Medserv, Sao Paulo, Brazil.
authors.forename: Kleyton
authors.initials: K
authors.lastname: Bastos
authors.forename: Luis Antonio
authors.initials: LA
authors.lastname: Lucarelli
authors.forename: Elizabeth
authors.initials: E
authors.lastname: De Francesco-Daher
authors.forename: Roberto Pecoits
authors.initials: RP
authors.lastname: Filho
authors.forename: Carlos
authors.initials: C
authors.lastname: Henríquez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Espinoza
authors.forename: Ignacio
authors.initials: I
authors.lastname: Villanueva
authors.forename: Emma
authors.initials: E
authors.lastname: Schwedt
authors.forename: Ruben
authors.initials: R
authors.lastname: Schiavelli
authors.forename: Ricardo
authors.initials: R
authors.lastname: Correa-Rotter
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood* / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006397:Hematinics / Q000008:administration & dosage* / Q000009:adverse effects; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007279:Injections, Subcutaneous; D007501:Iron / Q000627:therapeutic use; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications*; D013020:South America; D014131:Trace Elements / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D014131:Trace Elements; C508420:continuous erythropoietin receptor activator; D004921:Erythropoietin; D011092:Polyethylene Glycols; D007501:Iron