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Published in: International Urology and Nephrology 5/2013

Open Access 01-10-2013 | Nephrology - Original Paper

C.E.R.A. maintains stable hemoglobin in Latin American patients on dialysis

Authors: Kleyton Bastos, Luis Antonio Lucarelli, Elizabeth De Francesco-Daher, Roberto Pecoits Filho, Carlos Henríquez, Beatriz Espinoza, Ignacio Villanueva, Emma Schwedt, Ruben Schiavelli, Ricardo Correa-Rotter

Published in: International Urology and Nephrology | Issue 5/2013

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Abstract

Background

C.E.R.A. is a continuous erythropoietin receptor activator with characteristics that permit a once-monthly schedule of administration for the maintenance treatment for chronic kidney disease (CKD) patients. The main objective of this study was to assess the maintenance of Hb concentration with once-monthly intravenous and/or subcutaneous C.E.R.A. therapy in Latin American dialysis patients with chronic renal anemia previously treated with epoetin alfa s.c or i.v 1–3 times per week.

Methods

This was a single-arm, open-label, multicenter, 32-week study of anemic patients with CKD previously treated with epoetin alfa sc or iv 1–3 times per week. After a 4-week screening period, during which mean Hb levels were maintained between 10.5 and 12.5 g/dL on their previous erythropoiesis stimulating agent, eligible patients entered a 16-week C.E.R.A. dose titration period followed by a 4-week efficacy evaluation period (EEP) and a 28-week safety follow-up. The starting dose of C.E.R.A. was based on the previous dose of epoetin alfa. Doses of C.E.R.A. were then adjusted to maintain Hb levels within ±1.0 g/dL of the reference concentration and between 10.5 and 12.5 g/dL. The Hb reference concentration was defined as the mean of all Hb levels during screening. The primary end point was the proportion of patients maintaining a mean Hb concentration (g/dL) within ±1 g/dL of their reference Hb and between 10.5 and 12.5 g/dL during the EEP.

Results

A total of 163 patients from 27 centers in Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay, and Venezuela entered the treatment period and 102 completed the prescribed course of C.E.R.A. Forty-five patients (43.7 %) maintained a mean Hb concentration within ±1 g/dL of their reference Hb value and between 10.5 and 12.5 g/dL during the EEP. The median monthly dose remained constant at 120 μg during the titration period and during the EEP. On the average, there were only 2.3 dose changes per patient in 28 weeks of treatment, covering 7 C.E.R.A. scheduled administrations. 53 % of all dose changes were dose decreases, 47 % increases. A total of 10 AEs and 4 SAEs were considered to be related to the study treatment.

Conclusions

Once-monthly C.E.R.A. treatment effectively maintains stable Hb concentrations in patients with chronic renal anemia undergoing dialysis with a good safety and tolerability profile.
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Metadata
Title
C.E.R.A. maintains stable hemoglobin in Latin American patients on dialysis
Authors
Kleyton Bastos
Luis Antonio Lucarelli
Elizabeth De Francesco-Daher
Roberto Pecoits Filho
Carlos Henríquez
Beatriz Espinoza
Ignacio Villanueva
Emma Schwedt
Ruben Schiavelli
Ricardo Correa-Rotter
Publication date
01-10-2013
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 5/2013
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-012-0272-3

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