Dosing regimen and tolerability of methoxy polyethylene glycol–epoetin beta in Chinese dialysis patients. Issue 8 (18th July 2013)

• Record Type: Journal Article
• Authors: Choy, Bo Ying; Lam, Man Fai; Yip, Terence; Tang, Hon Lok; Wong, Ping Nam; Chow, Chik Cheung Vincent; Yap, Desmond YH; Chan, Tak Mao
• Is Part Of: Nephrology. Volume 18:Issue 8(2013)
• Page Start: 533
• Page End: 538
• Publication Date: 2013-07-18
• Subjects: anaemia -- darbepoetin alpha -- dialysis -- erythropoiesis‐stimulating agent -- methoxy polyethylene glycol‐epoetin beta; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.12105
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Aim: To investigate methoxy polyethylene glycol‐epoetin beta dosing regimen in treatment naïve subjects and dose conversion in darbepoetin alpha treated subjects, in Chinese dialysis patients. Methods: Adult Chinese patients on peritoneal dialysis (PD) or haemodialysis (HD), with no prior treatment with erythropoiesis‐stimulating agents and haemoglobin below 8 g/dL (Group I) or receiving darbepoetin alpha and had stable haemoglobin at 10–12 g/dL (Group II) were included in this prospective open‐label study. In Group I methoxy polyethylene glycol‐epoetin beta was started at 0.6 μg/kg subcutaneously fortnightly till haemoglobin reached 10 g/dL, after which it was given monthly. A dose conversion table was devised for Group II. Follow‐up was 36 weeks. Results: Forty‐five patients were included. Haemoglobin in Group I ( n = 23, PD/HD:19/4) increased from 7.5 ± 0.9 g/dL at baseline to 10.7 ± 1.0 g/dL after 16 weeks, while it remained stable at 10.4 ± 1.0 g/dL after conversion in Group II ( n = 22, PD/HD:15/7). Actual dose required after stabilization was 1.7 μg/kg per month in Group I and 2.3 μg/kg per month in Group II. Median number of dose adjustment was three in Group I and one in Group II, while haemoglobin overshoot to 13 g/dL or above occurred in 4.4% and 9.1%, respectively. No significant side‐effect was observed. Conclusions: Our dosing regimen for methoxy polyethylene glycol‐epoetin beta, for treatment naïve subjects or for conversion from darbepoetin alpha, is safe and effective. The dose required to achieve a haemoglobin concentration of 10–11 g/dL in Chinese dialysis patients is approximately 2 μg/kg monthly. Summary at a Glance: This two‐part open label study establishes: (i) a safe effective initiating regime for methyl polyethylene glycol epoetin beta in ESA‐naive Chinese dialysis patients; and (ii) an effective regime for dose conversion from darbepoetin alpha to methyl polyethylene glycol epoetin beta in Chinese dialysis patients.