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CERA conversion to darbepoetin alfa in 154 hemodialysis patients

  • Nephrology - Original Paper
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Abstract

Purpose

Anemia is a common complication in dialysis patients, usually treated with erythropoietin (EPO). Among available EPOs and analogs, continuous erythropoietin receptor activator (CERA) and darbepoetin alfa (DA) are the only two agents with a long duration of action, although they have almost never been formally compared in terms of efficacy. We took advantage of an accidental disruption in CERA supply to study the effect of its replacement with DA in the same patients.

Methods

The clinical and biological characteristics of 154 hemodialysis patients were retrospectively reviewed during the last 3 months on CERA compared to the first 4 months after replacement by DA, both ASE being administered by IV route. The comparison included EPO doses, hemoglobin levels, factors interfering with anemia (iron status assessment, iron doses, inflammation, quality of treatment) and was performed under the Bayesian paradigm.

Results

We found no significant differences between the two EPOs in terms of doses or hemoglobin concentrations. Factors that could potentially influence hemoglobin concentrations also did not differ under CERA or DA. The stability of hemoglobin was identical with both EPOs. We provide a conversion factor which allows comparison of cost according to local prices.

Conclusions

We conclude that, in this observational “real life” study, the two EPOs are to be considered as equivalent.

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Abbreviations

ESA:

Erythropoiesis stimulating agent

CERA:

Continuous erythropoietin receptor activator

DA:

Darbepoetin alfa

EPO:

Erythropoietin

CKD:

Chronic kidney disease

Hb:

Hemoglobin concentration

TSC:

Transferrin saturation coefficient

iPTH:

Immunoreactive parathyroid hormone

CRP:

C-reactive protein

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Funding

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Author information

Authors and Affiliations

  1. Nephrology Department, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, 67500, Haguenau, France

    Yves Dimitrov

  2. Dialysis Unit, AURAL, 5 Rue Henri Bergson, 67200, Strasbourg, France

    Yves Dimitrov, Philippe Petitjean, Alexandre Klein, François Chantrel & Thierry Hannedouche

  3. Pharmacy Department, Centre Hospitalier de Haguenau, 64 Avenue du Professeur Leriche, 67500, Haguenau, France

    Julie Rieger

  4. Nephrology Department, Hôpitaux Universitaires de Strasbourg, 1 Place de L’Hôpital, 67091, Strasbourg, France

    Thierry Krummel & Thierry Hannedouche

  5. Nephrology Department, Clinique St Anne, Rue Philippe Thyss, 67000, Strasbourg, France

    Philippe Petitjean

  6. Nephrology Department, Hôpitaux Civils de Colmar, 39 Avenue de la Liberté, 68024, Colmar, France

    Alexandre Klein

  7. Nephrology Department, Centre Hospitalier de Mulhouse, 87 Avenue d’Altkirch, 68051, Mulhouse, France

    François Chantrel

  8. Public Health Departement, GRMC, Hôpitaux Universitaires de Strasbourg, 1 Place de L’Hôpital, 67091, Strasbourg, France

    Nicolas Meyer

Authors
  1. Yves Dimitrov
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  2. Julie Rieger
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  3. Thierry Krummel
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  4. Philippe Petitjean
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  5. Alexandre Klein
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  6. François Chantrel
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  7. Nicolas Meyer
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  8. Thierry Hannedouche
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Contributions

YD, JR and TH designed the study. PP, AK and FC obtained the data and were responsible for the data management. NM and TK analyzed the data. All authors contributed to drafting and writing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yves Dimitrov.

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The authors declare that they have no conflict of interest.

Ethical approval

Not needed for this retrospective study.

Consent to participate

All patients gave their consent to the use of the datas.

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Dimitrov, Y., Rieger, J., Krummel, T. et al. CERA conversion to darbepoetin alfa in 154 hemodialysis patients. Int Urol Nephrol 52, 1979–1985 (2020). https://doi.org/10.1007/s11255-020-02569-w

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  • DOI: https://doi.org/10.1007/s11255-020-02569-w

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