TY - JOUR
T1 - Comparison between short- and long-acting erythropoiesis-stimulating agents in hemodialysis patients
T2 - Target hemoglobin, variability, and outcome
AU - Bernieh, Bassam
AU - Abouchacra, Samra
AU - Boobes, Yousef
AU - Al Hakim, Mohammad R.
AU - Nagelkerke, Nico
AU - Chaaban, Ahmad
AU - Ahmed, Mohamad
AU - Hussain, Qutaiba
AU - Jack, Hanan El
AU - Abayechi, Faiz
AU - Khan, Imran
AU - Gebran, Nicole
PY - 2014/2
Y1 - 2014/2
N2 - Purpose: Maintaining target hemoglobin (Hb) with minimal variability is a challenge in hemodialysis (HD) patients. The aim of this study is to compare the long- and short-acting erythropoietin-stimulating agents such as Aranesp and Eprex in achieving these targets. Methods: Randomized, prospective, open-labeled study of 24 weeks includes stable patients on HD >3 months, age >18 years, and on Eprex for >3 months. Patients were randomized into two groups: A-(Aranesp group):HD patients on Eprex Q TIW or BIW were converted to Aranesp Q weekly, by using the conversion factor of 200:1 and those on Eprex Q weekly to Aranesp Q 2 weeks; B-(Eprex group):patients continued on Eprex treatment. Hemoglobin target was set at (105-125 g/l). Primary end points were percentage of patients achieving target Hb, hemoglobin variability, and number of dose changes in each group. Results: This study consisted of 139 HD patients: 72 in the Aranesp and 67 in the Eprex-mean (SD) age 54 (16.2) years, 77 (55 %) males. About 46 % were diabetic. Target Hb achieved in 64.8 % of the Aranesp and 59.7 % in the Eprex (p = 0.006). Hb variability was less frequent in the Aranesp group (p = 0.2). Mean number of dose changes was 1.3 (0.87) in the Aranesp and 1.9 (1.2) in the Eprex (p < 0.001). There was 1 vascular access thrombosis in the Aranesp and 8 in the Eprex (p < 0.001). There was no difference in hospitalization and death number between the 2 groups. Conclusions: Aranesp Q weekly or every 2 weeks is more efficient in achieving target Hb, with less dose changes and minor vascular access complications.
AB - Purpose: Maintaining target hemoglobin (Hb) with minimal variability is a challenge in hemodialysis (HD) patients. The aim of this study is to compare the long- and short-acting erythropoietin-stimulating agents such as Aranesp and Eprex in achieving these targets. Methods: Randomized, prospective, open-labeled study of 24 weeks includes stable patients on HD >3 months, age >18 years, and on Eprex for >3 months. Patients were randomized into two groups: A-(Aranesp group):HD patients on Eprex Q TIW or BIW were converted to Aranesp Q weekly, by using the conversion factor of 200:1 and those on Eprex Q weekly to Aranesp Q 2 weeks; B-(Eprex group):patients continued on Eprex treatment. Hemoglobin target was set at (105-125 g/l). Primary end points were percentage of patients achieving target Hb, hemoglobin variability, and number of dose changes in each group. Results: This study consisted of 139 HD patients: 72 in the Aranesp and 67 in the Eprex-mean (SD) age 54 (16.2) years, 77 (55 %) males. About 46 % were diabetic. Target Hb achieved in 64.8 % of the Aranesp and 59.7 % in the Eprex (p = 0.006). Hb variability was less frequent in the Aranesp group (p = 0.2). Mean number of dose changes was 1.3 (0.87) in the Aranesp and 1.9 (1.2) in the Eprex (p < 0.001). There was 1 vascular access thrombosis in the Aranesp and 8 in the Eprex (p < 0.001). There was no difference in hospitalization and death number between the 2 groups. Conclusions: Aranesp Q weekly or every 2 weeks is more efficient in achieving target Hb, with less dose changes and minor vascular access complications.
KW - Hemodialysis
KW - Hemoglobin variability
KW - Long-acting ESAs
KW - Short
KW - Target hemoglobin
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U2 - 10.1007/s11255-013-0640-7
DO - 10.1007/s11255-013-0640-7
M3 - Article
C2 - 24448756
AN - SCOPUS:84896702519
SN - 0301-1623
VL - 46
SP - 453
EP - 459
JO - International Urology and Nephrology
JF - International Urology and Nephrology
IS - 2
ER -