Switch From Darbepoetin to Epoetin May Be Beneficial

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LAS VEGAS—Switching anemic pre-dialysis chronic kidney disease (CKD) from  darbepoetin to epoetin is associated with longer dosing intervals and lower drug costs, and hemoglobin levels are maintained in the recommended target range, according to a study presented at the National Kidney Foundation's Spring Clinical Meetings.

The study, by Martin Lunde, MD, of Twin Cities Clinical Research in Minneapolis, and colleagues, was a retrospective and observational analysis of electronic medical record data in pre-dialysis CKD patients who initially were treated with darbepoetin but then converted to epoetin.

To be included in the study, patients had to be aged 18 years and older, have had more than one medical claim for CKD, received two or more doses of both darbepoetin and epoetin, and received 180 days or more of treatment of either side of the conversion. The 170 patients who met inclusion criteria had a mean age of 70.3 years, and 64.7% were female. The mean dosing interval was greater during epoetin than darbepoetin treatment (37.2 vs. 33.4 days).

Mean Hb levels were statistically different but maintained close to 11 g/dL (11.2 with darbepoetin vs. 10.9 with epoetin). The associated mean weekly ESA costs were $196 for darbepoetin and $112 for epoetin,  reflecting a 75% darbepoetin price premium.

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