The efficiency and safety of methoxy polyethylene glycol-epoetin beta usage in patients with dialysis, who are transitioning from short-acting epoethins

INTRODUCTION. Methoxy polyethylene glycol-epoetin beta (PEG-EPO) is a representative of a third-generation erythropoiesis-stimulating agent with a continuous erythropoietin receptor activator (CERA). Although the effectiveness of methoxy polyethylene glycol-epoetin beta has been confirmed in multicenter randomized clinical trials, research continues to examine the safety and tolerability in patients with chronic renal anemia previously treated with recombinant human erythropoietins (rhEpo) of the first generation. AIMS. Evaluation of the efficacy and safety during the transition from rhEpo of first generation epoetin alpha (Epocrin, Aeprin, Eralfon) to third generation continuous activator erythropoietin receptor (CERA), methoxy polyethyleneglycol-epoetin beta (Mircera) administered intravenously every 4 weeks to maintain a stable hemoglobin (Hb) in patients with EPO-dependent anemia in programed hemodialysis (PhD). PATIENTS AND METHODS. A retrospective study was conducted enrolling 116 patients with terminal stage renal failure. They all were undergoing the renal replacement therapy with programmed hemodialysis, and were all being transferred from rhEpo of the first generation (months from -12 to -1) to CERA (Mircera) (months from1 to 12). As rhEpo first generation drugs with epoetin alpha (Alpha-EPO) were used Epocrin, Aeprin, Eralfon. RESULTS. 1. The use of CERA allows one to maintain a stable level of hemoglobin, with smooth dynamics. In sharp contrast, the short-acting epoetins induce drastic fluctuations. 2. The dose modification in the CERA (Mircera) therapy was half as frequent, compared to the frequency of dose modification in the alpha-EPO therapy (1.4±0.15 and 2.1 ± 0.3 episodes/year, respectively). 3. Adverse events associated with the use of CERA (Mircera) were rare. An increase in blood pressure indicators was revealed in CERA (Mircera) therapy, compared with the use of alpha-EPO. CONCLUSION. The use of CERA (Mircera) allows for the effective and safe maintaince of stable hemoglobin level in patients receiving treatment with program hemodialysis.

hemodialysis, anemia, continuous erythropoietin receptor activator

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