Conversion from Aranesp® to NESP® in dialysis patients—Exploration of dosing strategies and the feasibility of extending the dosing interval. Issue 9 (20th April 2021)

• Record Type: Journal Article
• Authors: Mok, Maggie M. Y.; Kwan, Lorraine P. Y.; Chan, Gary C. W.; Ma, Maggie K. M.; Wang, Angela Y. M.; Yap, Desmond Y. H.; Choy, Cindy B. Y.; Tang, Sydney C. W.; Chan, Tak Mao
• Is Part Of: Nephrology. Volume 26:Issue 9(2021)
• Page Start: 733
• Page End: 741
• Publication Date: 2021-04-20
• Subjects: anaemia -- dialysis -- darbepoetin alfa -- erythropoietin -- therapeutics; Nephrology -- Periodicals; Kidneys -- Diseases -- Periodicals; Nephrologists -- Periodicals; 616.61; 616.61
• DOI: 10.1111/nep.13882
• Languages: English
• ISSNs: 1320-5358

Abstract

Abstract: Aim: Darbepoetin alpha is available as Aranesp® and NESP®, which differ in the inactive component and maximum dose‐strength of prefilled syringes. We conducted an observational cohort study to investigate optimal conversion strategies and the feasibility of extending dosing intervals with higher‐dose preparations in dialysis patients converting from Aranesp® to NESP®. Methods: Adult dialysis patients on Aranesp® with stable haemoglobin of 9–12 g/dL were converted to NESP® at the same monthly total dose according to one of three conversion regimens. Group A included patients on ≤80 mcg/month of Aranesp® who converted with dosing regimen unchanged. Group B patients converted to NESP® with extended dosing intervals using higher individual dose preparations. Group C were patients on 100 mcg Aranesp® who converted to NESP® 120 mcg with extended dosing intervals. Patients were observed for 6 months. Results: Fifty patients were included. All 24 Group A patients maintained stable haemoglobin. In Group B, 10 patients (50%) maintained stable haemoglobin with extension of dosing interval from 1.04 ± 0.14 to 3.03 ± 1.28 weeks. Factors associated with success in extending dosing interval included a lower prevalence of cardiovascular disease and a higher Kt/Vurea in peritoneal dialysis patients. Four patients (80%) in Group C maintained stable haemoglobin after conversion to NESP® 120 mcg with extended dosing interval. The use of NESP® 120 mcg was well tolerated, and was associated with reduced patient‐reported pain score and 38% reduction of drug cost. Conclusion: Dialysis patients on Aranesp® can be successfully converted to NESP® and the dosing interval can be extended successfully in a significant proportion of patients, which could reduce discomfort and drug cost. SUMMARY AT A GLANCE: This prospective study showed that a substantial proportion of dialysis patients treated with Aranesp® could be successfully converted to NESP®. The dosing interval could be extended, which would reduce discomfort and drug cost.