Recombinant human erythropoietin (rHuEPO), such as the approved agents epoetin alfa and epoetin beta, has been used successfully for over 20 years to treat anemia in millions of patients. However, due to the relatively short half-life of the molecule (approximately 8 hours), frequent dosing may be required to achieve required hemoglobin levels. Therefore, a need was identified in some anemic patient populations for erythropoiesis stimulating agents with longer half-lives that required less frequent dosing. This need led to the development of second generation molecules which are modified versions of rHuEPO with improved pharma-cokinetic and pharmacodynamic properties such as darbepoetin alfa, a hyperglycosylated analog of rHuEPO, and pegzyrepoetin, a pegylated rHuEPO. Third generation molecules, such as peginesatide, which are peptide mimetics that have no sequence homology to rHuEPO have also recently been developed. The various molecular, pharmacokinetic, and pharmacodynamic properties of these and other erythropoiesis stimulating agents will be discussed in this review.
机构:
Univ Ljubljana, Fac Med, Inst Biochem, Ljubljana 61000, SloveniaHarvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Hematol & Oncol, Boston, MA 02215 USA
Debeljaka, Natasa
Sytkowski, Arthur J.
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机构:
Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Hematol & Oncol, Boston, MA 02215 USA
Quintiles Transnat, Oncol Therapeut Delivery Unit, Rockville, MD USAHarvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Div Hematol & Oncol, Boston, MA 02215 USA
机构:
New York Med Coll, Valhalla, NY 10595 USA
Our Lady Mercy Med Ctr, Dept Med, Bronx, NY USA
Our Lady Mercy Med Ctr, Div Geriatr, Bronx, NY USA
Our Lady Mercy Med Ctr, Geriatr Med Fellowship Program, Bronx, NY USANew York Med Coll, Valhalla, NY 10595 USA