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Published in: BMC Nephrology 1/2009

Open Access 01-12-2009 | Research article

Anaemia management with subcutaneous epoetin delta in patients with chronic kidney disease (predialysis, haemodialysis, peritoneal dialysis): results of an open-label, 1-year study

Authors: Ulrich Frei, Jonathan TC Kwan, Bruce S Spinowitz, The Epoetin Delta 3002 Study Group

Published in: BMC Nephrology | Issue 1/2009

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Abstract

Background

Anaemia is common in patients with chronic kidney disease (CKD) and can be managed by therapy with erythropoiesis-stimulating agents (ESAs). Epoetin delta (DYNEPO®, Shire plc) is the only epoetin produced in a human cell line. The aim of this study was to demonstrate the safety and efficacy of subcutaneously administered epoetin delta for the management of anaemia in CKD patients (predialysis, peritoneal dialysis or haemodialysis)

Methods

This was a 1-year, multicentre, open-label study. Patients had previously received epoetin subcutaneously and were switched to epoetin delta at an identical dose to their previous therapy. Dose was titrated to maintain haemoglobin at 10.0–12.0 g/dL. The primary endpoint was mean haemoglobin over Weeks 12–24. Secondary analyses included long-term haemoglobin, haematocrit and dosing levels. Safety was assessed by monitoring adverse events, laboratory parameters and physical examinations.

Results

In total 478 patients received epoetin delta, forming the safety-evaluable population. Efficacy analyses were performed on data from 411 of these patients. Mean ± SD haemoglobin over Weeks 12–24 was 11.3 ± 1.1 g/dL. Mean ± SD weekly dose over Weeks 12–24 was 84.4 ± 72.7 IU/kg. Haemoglobin levels were maintained for the duration of the study. Epoetin delta was well tolerated, with adverse events occurring at rates expected for a CKD patient population; no patient developed anti-erythropoietin antibodies.

Conclusion

Subcutaneously administered epoetin delta is an effective and well-tolerated agent for the management of anaemia in CKD patients, irrespective of dialysis status.

Trial registration

Appendix
Available only for authorised users
Literature
1.
go back to reference Hsu CY, McCulloch CE, Curhan GC: Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol. 2002, 13: 504-510. 10.1097/01.ASN.0000034200.82278.DC.CrossRefPubMed Hsu CY, McCulloch CE, Curhan GC: Epidemiology of anemia associated with chronic renal insufficiency among adults in the United States: results from the Third National Health and Nutrition Examination Survey. J Am Soc Nephrol. 2002, 13: 504-510. 10.1097/01.ASN.0000034200.82278.DC.CrossRefPubMed
2.
go back to reference McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, Tse TF, Wasserman B, Leiserowitz M: The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin. 2004, 20: 1501-1510. 10.1185/030079904X2763.CrossRefPubMed McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, Tse TF, Wasserman B, Leiserowitz M: The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin. 2004, 20: 1501-1510. 10.1185/030079904X2763.CrossRefPubMed
3.
go back to reference Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, Schwab SJ, Goodkin DA: The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med. 1998, 339: 584-590. 10.1056/NEJM199808273390903.CrossRefPubMed Besarab A, Bolton WK, Browne JK, Egrie JC, Nissenson AR, Okamoto DM, Schwab SJ, Goodkin DA: The effects of normal as compared with low hematocrit values in patients with cardiac disease who are receiving hemodialysis and epoetin. N Engl J Med. 1998, 339: 584-590. 10.1056/NEJM199808273390903.CrossRefPubMed
4.
go back to reference Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. Canadian Erythropoietin Study Group. BMJ. 1990, 300: 573-578. Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. Canadian Erythropoietin Study Group. BMJ. 1990, 300: 573-578.
5.
go back to reference Revicki DA, Brown RE, Feeny DH, Henry D, Teehan BP, Rudnick MR, Benz RL: Health-related quality of life associated with recombinant human erythropoietin therapy for predialysis chronic renal disease patients. Am J Kidney Dis. 1995, 25: 548-554. 10.1016/0272-6386(95)90122-1.CrossRefPubMed Revicki DA, Brown RE, Feeny DH, Henry D, Teehan BP, Rudnick MR, Benz RL: Health-related quality of life associated with recombinant human erythropoietin therapy for predialysis chronic renal disease patients. Am J Kidney Dis. 1995, 25: 548-554. 10.1016/0272-6386(95)90122-1.CrossRefPubMed
6.
go back to reference Locatelli F, Aljama P, Barany P, Canaud B, Carrera F, Eckardt KU, Horl WH, Macdougal IC, Macleod A, Wiecek A, et al: Revised European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant. 2004, 19 (Suppl 2): ii1-47. 10.1093/ndt/gfh1032.PubMed Locatelli F, Aljama P, Barany P, Canaud B, Carrera F, Eckardt KU, Horl WH, Macdougal IC, Macleod A, Wiecek A, et al: Revised European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant. 2004, 19 (Suppl 2): ii1-47. 10.1093/ndt/gfh1032.PubMed
7.
go back to reference Deicher R, Horl WH: Differentiating factors between erythropoiesis-stimulating agents: a guide to selection for anaemia of chronic kidney disease. Drugs. 2004, 64: 499-509. 10.2165/00003495-200464050-00004.CrossRefPubMed Deicher R, Horl WH: Differentiating factors between erythropoiesis-stimulating agents: a guide to selection for anaemia of chronic kidney disease. Drugs. 2004, 64: 499-509. 10.2165/00003495-200464050-00004.CrossRefPubMed
8.
go back to reference Shahrokh Z, Flatman S, Davies M, Baycroft A, Heartlein M: Erythropoietin produced by a human cell line has only trace levels of potentially immunogenic N-glycolylneuraminic acid residues. haematologica/the hematology journal. 2006, 91 (Suppl 1): 208- Shahrokh Z, Flatman S, Davies M, Baycroft A, Heartlein M: Erythropoietin produced by a human cell line has only trace levels of potentially immunogenic N-glycolylneuraminic acid residues. haematologica/the hematology journal. 2006, 91 (Suppl 1): 208-
9.
go back to reference Spinowitz BS, Pratt RD: Epoetin delta is effective for the management of anaemia associated with chronic kidney disease. Curr Med Res Opin. 2006, 22: 2507-2513. 10.1185/030079906X158048.CrossRefPubMed Spinowitz BS, Pratt RD: Epoetin delta is effective for the management of anaemia associated with chronic kidney disease. Curr Med Res Opin. 2006, 22: 2507-2513. 10.1185/030079906X158048.CrossRefPubMed
10.
go back to reference Pratt RD: Epoetin delta for the treatment of anemia in patients with CKD not requiring haemodialysis. Poster presented at the American Society of Nephrology Renal Week. 2006 Pratt RD: Epoetin delta for the treatment of anemia in patients with CKD not requiring haemodialysis. Poster presented at the American Society of Nephrology Renal Week. 2006
11.
go back to reference Martin KJ: Epoetin delta in the management of renal anaemia: results of a 6-month study. Nephrol Dial Transplant. 2007, 22: 3052-3054. 10.1093/ndt/gfm490.CrossRefPubMed Martin KJ: Epoetin delta in the management of renal anaemia: results of a 6-month study. Nephrol Dial Transplant. 2007, 22: 3052-3054. 10.1093/ndt/gfm490.CrossRefPubMed
12.
go back to reference Martin KJ: The first human cell line-derived erythropoietin, epoetin-delta (Dynepo), in the management of anemia in patients with chronic kidney disease. Clin Nephrol. 2007, 68: 26-31.CrossRefPubMed Martin KJ: The first human cell line-derived erythropoietin, epoetin-delta (Dynepo), in the management of anemia in patients with chronic kidney disease. Clin Nephrol. 2007, 68: 26-31.CrossRefPubMed
13.
go back to reference Kwan JT, Pratt RD: Epoetin delta, erythropoietin produced in a human cell line, in the management of anaemia in predialysis chronic kidney disease patients. Curr Med Res Opin. 2007, 23: 307-311. 10.1185/030079906X162755.CrossRefPubMed Kwan JT, Pratt RD: Epoetin delta, erythropoietin produced in a human cell line, in the management of anaemia in predialysis chronic kidney disease patients. Curr Med Res Opin. 2007, 23: 307-311. 10.1185/030079906X162755.CrossRefPubMed
14.
go back to reference Smith WB, Dowell JA, Pratt RD: Pharmacokinetics and pharmacodynamics of epoetin delta in two studies in healthy volunteers and two studies in patients with chronic kidney disease. Clin Ther. 2007, 29: 1368-1380. 10.1016/j.clinthera.2007.07.014.CrossRefPubMed Smith WB, Dowell JA, Pratt RD: Pharmacokinetics and pharmacodynamics of epoetin delta in two studies in healthy volunteers and two studies in patients with chronic kidney disease. Clin Ther. 2007, 29: 1368-1380. 10.1016/j.clinthera.2007.07.014.CrossRefPubMed
15.
go back to reference Weiss LG, Clyne N, Divino Fihlho J, Frisenette-Fich C, Kurkus J, Svensson B: The efficacy of once weekly compared with two or three times weekly subcutaneous epoetin beta: results from a randomized controlled multicentre trial. Swedish Study Group. Nephrol Dial Transplant. 2000, 15: 2014-2019. 10.1093/ndt/15.12.2014.CrossRefPubMed Weiss LG, Clyne N, Divino Fihlho J, Frisenette-Fich C, Kurkus J, Svensson B: The efficacy of once weekly compared with two or three times weekly subcutaneous epoetin beta: results from a randomized controlled multicentre trial. Swedish Study Group. Nephrol Dial Transplant. 2000, 15: 2014-2019. 10.1093/ndt/15.12.2014.CrossRefPubMed
16.
go back to reference Locatelli F, Baldamus CA, Villa G, Ganea A, Martin de Francisco AL: Once-weekly compared with three-times-weekly subcutaneous epoetin beta: results from a randomized, multicenter, therapeutic-equivalence study. Am J Kidney Dis. 2002, 40: 119-125. 10.1053/ajkd.2002.33920.CrossRefPubMed Locatelli F, Baldamus CA, Villa G, Ganea A, Martin de Francisco AL: Once-weekly compared with three-times-weekly subcutaneous epoetin beta: results from a randomized, multicenter, therapeutic-equivalence study. Am J Kidney Dis. 2002, 40: 119-125. 10.1053/ajkd.2002.33920.CrossRefPubMed
17.
go back to reference European best practice guidelines for the management of anaemia in patients with chronic renal failure. Working Party for European Best Practice Guidelines for the Management of Anaemia in Patients with Chronic Renal Failure. Nephrol Dial Transplant. 1999, 14 (Suppl 5): 1-50. European best practice guidelines for the management of anaemia in patients with chronic renal failure. Working Party for European Best Practice Guidelines for the Management of Anaemia in Patients with Chronic Renal Failure. Nephrol Dial Transplant. 1999, 14 (Suppl 5): 1-50.
Metadata
Title
Anaemia management with subcutaneous epoetin delta in patients with chronic kidney disease (predialysis, haemodialysis, peritoneal dialysis): results of an open-label, 1-year study
Authors
Ulrich Frei
Jonathan TC Kwan
Bruce S Spinowitz
The Epoetin Delta 3002 Study Group
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2009
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-10-5

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