Switching From Epoetin to Darbepoetin Alfa: Impact on Anemia Management
Francis Dumler, from William Beaumont Hospital, in Royal Oak, Michigan, presented the results of the impact of a Formulary switch from epoetin alfa to darbepoetin alfa on hemoglobin concentration in chronic hemodialysis patients. This was a prospective, longitudinal, observational study of 54 patients (mean age: 61 ± 16 years; 47% female; 30% black; 40% diabetics) treated by a single nephrologist. Median values for the quarter preceding the switch (PRE) were compared to the subsequent 3 months starting 30 days after the conversion (POST). Epoetin was administered intravenously 3 times/week and darbepoetin was administered intravenously once weekly. Results are shown in the table .
In addition, the median epoetin dose during the PRE period was 12,000 U/week and the median dabepoetin dose during the POST period was 60 mcg vs the package insert suggestion of 40 mcg/week. The conversion to darbepoetin alfa was performed according to the manufacturer's recommendation in the package insert, but because hemoglobin values fell 7%, the dosages had to be increased. In conclusion, conversion to IV darbepoetin should be calculated as 1 mcg per 200 U of epoetin.
Medscape Nephrology © 2007 Medscape
Cite this: Highlights of the Annual Dialysis Conference: Chronic Kidney Disease Related-Anemia - Medscape - Apr 02, 2007.