PMID: 16532992Mar 15, 2006Paper

Developing an algorithm to convert erythropoietin dosing to darbepoetin alfa

Nephrology News & Issues
John P Capelli, Harvey Kushner

Abstract

The erythropoietic-stimulating hormone, darbepoetin alfa (Aranesp; DPO; Amgen, Thousand Oaks, California) is a long-acting agent growing in popularity as the preferred anemia management agent for patients with chronic kidney disease. Use of this drug in existing patients treated with rHu-EPO (epoetin alfa; EPO) requires conversion dosing and the potential for serious alterations in previously stable and satisfactory hemoglobin levels. This study analyzed the dosing conversion recommended by Amgen to determine if the regimen resulted in stable hemoglobin values during the conversion. Twenty-nine stable patients on hemodialysis were selected for conversion from EPO to DPO. The dose of DPO was taken from the conversion table recommended by Amgen and based upon the patient's weekly EPO dose. The mean conversion dose was 40 mcg weekly. The patients were monitored monthly with hemoglobin, hematocrit routine chemistries, and iPTH levels according to unit policy. The dose of DPO was individually titrated to maintain the hemoglobin concentrations at target levels between 11.5 gm/dL and 13.3 gm/dL. At the end of six months, there was an analysis of the data to determine if the results warranted an adjustment in the DPO dose and if so, wh...Continue Reading

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