Rev. OFIL 2017, 27;2:171-178
Fecha de recepción: 16/05/2016 – Fecha de aceptación: 26/10/2016
Pérez-Diez C1, Navarro-Aznárez H1, Lou-Arnal LM2, Abad Sazatornil MR1
1 Servicio de Farmacia
2 Servicio de Nefrología
Hospital Universitario Miguel Servet. Zaragoza (España)
Cristina Pérez Diez
Hospital Universitario Miguel Servet
(Servicio de Farmacia)
Pº Isabel la Católica, 1-3
Correo electrónico: firstname.lastname@example.org
Purpose: Determination of epoetin β and darbepoetin α average dose required to achieve hemoglobin (Hb) 10.0-12.5 g/dl in predialysis patients and analysis of factors involved in the response.
Material and methods: Retrospective study. CKD patients who started treatment with EAs between January-December 2013 were included. Follow-up period: 6 months. Data collected: demographics; baseline, 3 and 6 months data analysis; comorbidities, EA dispensed and concomitant treatments. Data: medical and pharmacotherapeutic history (Farmatools®).
Results: 81 patients. Median baseline characteristics: 59.3% men, 74 years old (30-88), stage 3 (29.7%), 4 (57.8%) and 5 (12.5%); Hb 10.13±1.16 g/dl; 40.7% received epoetin β (average weekly dose: 7,718.18±6,155.72 UI) and 59.3% darbepoetin α (average weekly dose: 20.55 ± 10.30 µg). Hb level increased after 3 months of treatment (1.52 g/dl average increase, p<0.001) and 6 months (1.60 g/dl, p<0.001); and hematocrit level also did (4.82 g/dl, p<0.001) and (5.08 g/dl, p<0.001) respectively. After 3 months, 53.1% of patients had Hb 10.0-12.5 g/dl. Average weekly dose to achieve Hb target range: 6,875.0 UI of epoetin β and 20.4 µg of darbepoetin α, which represent a relationship between both doses: 337:1. Being a nonsmoker (p=0.004), suffering IC (p=0.006), taking IECAs (p=0.043) and epoetin β (p=0.003) are factors which decrease the effectiveness of treatment with EAs.
Conclusion: At 3 months, 50% of patients get response with a dose ratio between epoetin β and darbepoetin α of 300 IU/1µg.
Key Words: Anaemia, epoetin-β, earbepoetin-α, chronic-renal-failure, predialysis.