A randomized, multicenter study of subcutaneous and intravenous darbepoetin alfa for the treatment of chemotherapy-induced anemia

Abstract

Background: This randomized, open-label study evaluated the efficacy, safety and pharmacokinetics of darbepoetin alfa administered intravenously (i.v.) or subcutaneously (s.c.) in chemotherapy-induced anemia.

Patients and methods: Patients received darbepoetin alfa i.v. (n = 59) or s.c. (n = 59) at a dose of 4.5 μg/kg once weekly for 6 weeks (correction phase) followed by 4.5 μg/kg once every 3 weeks for the remainder of the 18-week treatment period (maintenance phase).

Results: During the correction phase, the mean [95% confidence interval (CI)] change in hemoglobin (intention-to-treat) was 1.1 (0.6–1.5) g/dl in the i.v. group and 1.3 (0.9–1.7) g/dl in the s.c. group; using available data, the mean change was 1.4 (1–1.9) g/dl and 1.6 (1.2–2) g/dl, respectively. The percentage (95% CI) of patients maintaining hemoglobin (i.e. average decrease ≤0.5 g/dl) during the maintenance phase was similar between the i.v. (82%; 95% CI 66% to 92%) and s.c. (80%; 95% CI 66% to 90%) groups. Thirty-five per cent (95% CI 20% to 50%) of patients in the i.v. group and 32% of patients in the s.c. group (95% CI 18% to 45%) received red blood cell transfusions during week 5 to the end of the treatment period. Darbepoetin alfa was well tolerated in both groups. No significant difference (P = 0.36) in weekly darbepoetin alfa serum concentrations was observed between groups.

Conclusions: Darbepoetin alfa can be administered i.v. or s.c. at equal doses for the treatment of anemia in this setting.