The efficacy and safety of once-weekly and once-fortnightly subcutaneous epoetin β in peritoneal dialysis patients with chronic renal anaemia

被引:26
作者
Grzeszczak, W
Sulowicz, W
Rutkowski, B
de Vecchi, AF
Scanziani, R
Durand, Y
Bajo, A
Vargemezis, V
机构
[1] Silesian Univ, Sch Med, Nephrol Clin, PL-41800 Zabrze, Poland
[2] Jagiellonian Univ, Coll Med, Dept Nephrol, Krakow, Poland
[3] Med Univ Sch, Nephrol Clin, Gdansk, Poland
[4] Maggiore Hosp, Div Nephrol, Milan, Italy
[5] Desio Hosp, Div Nephrol & Dialysis, Desio, Italy
[6] CHU Brabois, Assoc Altir, Vandoeuvre Les Nancy, France
[7] Hosp La Paz, Serv Nephrol, Madrid, Spain
[8] Univ Hosp Alexandroupolis, Dept Nephrol, Alexandroupolis, Greece
关键词
dosage; epoetin beta; peritoneal dialysis; renal anaemia; subcutaneous;
D O I
10.1093/ndt/gfh761
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Background. Reducing the dosage frequency of subcutaneous epoetin in peritoneal dialysis (PD) patients is convenient and should improve patient satisfaction and, possibly, compliance. We investigated if a weekly dosage of epoetin beta in PD patients safely maintained haemoglobin (Hb) concentrations equivalent to those obtained with previous twice- or thrice-weekly administration. In addition, we investigated if a fortnightly dosage of epoetin beta was safe and as effective as previous weekly administration. Methods. After a 4 week run-in period, PD patients were switched to either weekly or fortnightly epoetin beta administration, depending on their previous treatment schedules, for 25 weeks. Results. The per-protocol cohort included 128 patients, of whom 54 received epoetin beta once weekly and 74 once fortnightly. The mean change in Hb concentration from baseline over weeks 13-25 and the 90% confidence intervals (CIs) remained within the target range (10-12g/dl) and specified equivalence (+/- 0.75g/dl) limits in the weekly (-0.34g/dl; 90% Cl: -0.14 to -0.54g/dl) and fortnightly (-0.39g/dl; 90% Cl: -0.24 to -0.55g/dl) cohorts. The mean change from baseline in the epoetin beta dose was 1.4IU/kg/week (90% Cl: -3.8 to 6.6IU/kg/week; 2%) in the weekly cohort and 4.4IU/kg/week (90% Cl: 1.7-7.2IU/kg/week; 13%) in the fortnightly cohort. Both treatment regimens were well tolerated. Conclusions. In stable PD patients switched from twice- or thrice-weekly to weekly epoetin beta treatment, Hb concentrations could be maintained within the specified range over 25 weeks without significant change in their mean epoetin P doses. In patients switched from weekly to fortnightly treatment, Hb concentrations could also be maintained over 25 weeks. There was a small increase in the mean dose during this period, but >= 50% of patients could be maintained without dose increase. Reducing dosage frequency may improve compliance in PD patients who self-administer their epoetin.
引用
收藏
页码:936 / 944
页数:9
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