Literature DB >> 12426518

Pharmacokinetics and pharmacodynamics of darbepoetin alfa and epoetin in patients undergoing dialysis.

Michael Allon1, Kenneth Kleinman, Michael Walczyk, Charles Kaupke, Louise Messer-Mann, Kurt Olson, Anne C Heatherington, Bradley J Maroni.   

Abstract

OBJECTIVE: The aim of this multicenter, randomized, open-label study was to compare the pharmacokinetic and pharmacodynamic profiles of darbepoetin alfa, a new erythropoiesis-stimulating protein, and recombinant human erythropoietin (epoetin) after repeated intravenous dosing in patients with chronic kidney disease receiving hemodialysis.
METHODS: Forty-seven patients were randomized to receive darbepoetin alfa administered once weekly (n = 17) or 3 times weekly (n = 15) or epoetin administered 3 times weekly (n = 15) for up to 52 weeks. Pharmacokinetic profiles were measured during weeks 1 and 12 and at hemoglobin steady state (defined as a hemoglobin concentration within the target range for 4 consecutive weeks after week 12 with no change in study drug dose) or between weeks 36 and 40, whichever occurred first.
RESULTS: At each of the 3 time points evaluated, the terminal half-life of darbepoetin alfa was 2 to 3 times longer and the clearance approximately 4 times slower than those of epoetin. At week 12, the terminal half-life was 23.4 hours with darbepoetin alfa once weekly, 18.3 hours with darbepoetin alfa 3 times weekly, and 8.0 hours with epoetin 3 times weekly. The pharmacokinetics of darbepoetin alfa was not dependent on dose or time. Mean hemoglobin values at steady state were all approximately 11 g/dL, within the target range of 9.0 to 13.0 g/dL. Safety analyses revealed no differences between darbepoetin alfa and epoetin.
CONCLUSIONS: The pharmacokinetic and pharmacodynamic profiles and safety data for darbepoetin alfa demonstrate that it can be administered less frequently than epoetin in patients with chronic kidney disease receiving hemodialysis, thus simplifying anemia management.

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Year:  2002        PMID: 12426518     DOI: 10.1067/mcp.2002.128374

Source DB:  PubMed          Journal:  Clin Pharmacol Ther        ISSN: 0009-9236            Impact factor:   6.875


  22 in total

1.  The absorption of darbepoetin alfa occurs predominantly via the lymphatics following subcutaneous administration to sheep.

Authors:  Danielle N McLennan; Christopher J H Porter; Glenn A Edwards; Anne C Heatherington; Steven W Martin; Susan A Charman
Journal:  Pharm Res       Date:  2006-08-09       Impact factor: 4.200

2.  Population pharmacokinetics of darbepoetin alfa in healthy subjects.

Authors:  Balaji Agoram; Liviawati Sutjandra; John T Sullivan
Journal:  Br J Clin Pharmacol       Date:  2006-08-30       Impact factor: 4.335

3.  Population pharmacokinetics of darbepoetin alfa in haemodialysis and peritoneal dialysis patients after intravenous administration.

Authors:  Hirotaka Takama; Hideji Tanaka; Daisuke Nakashima; Hiroyasu Ogata; Eiji Uchida; Tadao Akizawa; Shozo Koshikawa
Journal:  Br J Clin Pharmacol       Date:  2006-08-31       Impact factor: 4.335

Review 4.  Clinical pharmacokinetics and pharmacodynamics of erythropoiesis-stimulating agents.

Authors:  Sameer Doshi; Wojciech Krzyzanski; Susan Yue; Steven Elliott; Andrew Chow; Juan José Pérez-Ruixo
Journal:  Clin Pharmacokinet       Date:  2013-12       Impact factor: 6.447

Review 5.  Mortality risk of darbepoetin alfa versus epoetin alfa in patients with CKD: systematic review and meta-analysis.

Authors:  Emilee R Wilhelm-Leen; Wolfgang C Winkelmayer
Journal:  Am J Kidney Dis       Date:  2015-01-28       Impact factor: 8.860

6.  Pharmacokinetic predictions for patients with renal impairment: focus on peptides and protein drugs.

Authors:  David Czock; Frieder Keller; Hanna M Seidling
Journal:  Br J Clin Pharmacol       Date:  2012-07       Impact factor: 4.335

7.  Development and evaluation of a population pharmacokinetic-pharmacodynamic model of darbepoetin alfa in patients with nonmyeloid malignancies undergoing multicycle chemotherapy.

Authors:  Balaji Agoram; Anne C Heatherington; Marc R Gastonguay
Journal:  AAPS J       Date:  2006-09-01       Impact factor: 4.009

Review 8.  Use of agents stimulating erythropoiesis in digestive diseases.

Authors:  Rosario Moreno López; Beatriz Sicilia Aladrén; Fernando Gomollón García
Journal:  World J Gastroenterol       Date:  2009-10-07       Impact factor: 5.742

Review 9.  Differentiating factors between erythropoiesis-stimulating agents: a guide to selection for anaemia of chronic kidney disease.

Authors:  Robert Deicher; Walter H Hörl
Journal:  Drugs       Date:  2004       Impact factor: 9.546

10.  Pharmacokinetics of darbepoetin alfa after intravenous or subcutaneous administration in patients with non-myeloid malignancies undergoing chemotherapy.

Authors:  Anne C Heatherington; Christian Dittrich; John T Sullivan; Greg Rossi; Johannes Schueller
Journal:  Clin Pharmacokinet       Date:  2006       Impact factor: 6.447

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