title: Efficacy and safety of darbepoetin alfa for anemia in children with chronic kidney disease: a multicenter prospective study in Japan.
abstract: BACKGROUND
  We evaluated the safety and efficacy of darbepoetin alfa (DA), an attractive alternative to recombinant human erythropoietin (rHuEPO) in managing renal anemia, in Japanese children with chronic kidney disease (CKD) on peritoneal dialysis (PD) and hemodialysis (HD), and not on dialysis (ND).
  
  
  METHODS
  A total of 31 pediatric CKD patients (13 PD, 2 HD, and 16 ND) were enrolled. DA was administered bi-weekly intravenously (IV) or subcutaneously (SC) for PD or ND patients, and weekly IV for HD patients for 24 weeks. The target Hb was defined as 11.0 to ≤13.0 g/dl. In patients receiving rHuEPO, the initial DA dose was calculated at 1 μg DA for 200 IU rHuEPO. The initial DA dose for naïve patients was determined by body weight, and intended not to exceed 0.5 μg/kg per administration. For some PD or ND patients, the dosing frequency was subsequently changed to once every 4 weeks.
  
  
  RESULTS
  Mean Hb values increased from 10.5 ± 1.1 to 11.1 ± 1.1 g/dl after 4 weeks of DA treatment. The target Hb was achieved in all patients, 64.5 % of whom maintained the value at completion of the study. Hb responses were similar between IV and SC. The dosing frequency was extended to once every 4 weeks in 37.9 % of PD or ND patients. Eighty-seven adverse events were noted in 27 (87.1 %) of 31 patients, none of which were associated with DA.
  
  
  CONCLUSIONS
  These results suggest that IV or SC administration of DA is an effective and safe treatment for renal anemia in Japanese children with CKD.
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan, hattori@kc.twmu.ac.jp.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.forename: Osamu
authors.initials: O
authors.lastname: Uemura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hataya
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
authors.forename: Masataka
authors.initials: M
authors.lastname: Hisano
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ohta
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Fujinaga
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kise
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Gotoh
authors.forename: Akira
authors.initials: A
authors.lastname: Matsunaga
authors.forename: Naoko
authors.initials: N
authors.lastname: Ito
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
mesh_terms: D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D000068256:Darbepoetin alfa / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006397:Hematinics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D007564:Japan; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D000068256:Darbepoetin alfa