Darbepoetin alfa can be administered safely either weekly or biweekly to achieve hemoglobin targets of 10–12 g/dL in pediatric patients with renal anemia and who previously have not been treated with an erythropoiesis-stimulating agent (ESA), researchers concluded.

Bradley A. Warady, MD, professor of pediatrics at the University of Missouri-Kansas City School of Medicine and director of pediatric nephrology at Children’s Mercy Kansas City, and colleagues tested the efficacy and safety of darbepoetin alfa in a cohort of 116 pediatric ESA-naïve patients with chronic kidney disease (aged 1 to 18 years) who had hemoglobin levels below 10 g/dL. The investigators randomly assigned patients to receive darbepoetin alfa once weekly or every 2 weeks. The drug was administered subcutaneously to patients not on dialysis or who were receiving peritoneal dialysis and intravenously to patients receiving hemodialysis. Darbepoetin alfa was titrated to achieve hemoglobin levels of 10–12 g/dL over 25 weeks.

Results published in Pediatric Nephrology (2018;33:125-137) showed that the mean hemoglobin concentrations in both groups increased to 11 g/dL or higher over the first 3 months of treatment and remained stable within the 10–12 g/dL target range. In addition, the investigators found that the median time to achieve hemoglobin levels of 10 g/dL or higher was slightly longer for patients aged less than 12 years compared with older patients. The groups had similar adverse event profiles, Dr Warady and his team reported.

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The investigators also measured patient- and parent-reported health-related outcomes among children aged 2 years or older using the Pediatric Quality of Life Inventory (PedsQL) instrument. PedsQL scores showed modest increases, according to the investigators.

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Warady BA, Barcia J, Benador N, et al. Do novo weekly and biweekly darbepoetin alfa dosing in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2018;33:125-137.