Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev ET
ISSN: 1312-773X (Online)
Issue: 2017, vol. 23, issue 1
Subject Area: Medicine
Pages: 1421-1426
DOI: 10.5272/jimab.2017231.1421
Published online: 17 January 2017

J of IMAB 2017 Jan-Mar;23(1):1421-1426
USE OF DARBEPOETIN ALFA (ARANESP®) FOR ANEMIA TREATMENT IN CHILDREN WITH CHRONIC KIDNEY DISEASE – CLINICAL EXPERIENCE OF BULGARIAN PEDIATRIC GROUP
Maria Gaydarova1Corresponding Autor, Anelia Boueva2, Svetlana Marinova1, Galina Zlatanova1.
1) Division of Nephrology, University Pediatric Hospital, Sofia, Bulgaria
2) Division of Nephrology, Specialized Hospital for Active Treatment of Children, Varna, Bulgaria.

ABSTRACT:
Darbepoetin alfa (DA) is indicated for treatment of symptomatic anemia related to chronic kidney disease (CKD) in adult and pediatric patients. In comparison with the recombinant human erythropoietin (rHuEpo), darbepoetin alfa has two additional carbohydrates containing sialic acid which prolong its half-life and enhance its biological activity in vivo. Herein, our clinical experience of using darbepoetin alfa (s.c.) for treatment of anemia in seven pediatric non-dialysis patients is presented. Subjects, aged 3-16 years were receiving (DA) for the period of 5 to 34 months to achieve and maintain hemoglobin levels between 100 and 120 g/l. Our secondary purpose was to establish whether the use of DA in children would reduce the frequency of painful injections, when administered subcutaneously, and improve the compliance of treatment. The early response of darbepoetin therapy was hemoglobin levels between 107 and 124 g/l. The subcutaneous administration of DA resulted in 2 dose corrections and showed that 86% of subjects achieved Hb level between 100 and 120 g/l.

Key words: Darbepoetin alfa, Anemia, Chronic kidney disease, Pediatrics,

- Download FULL TEXT /PDF 1051 KB/
Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Gaydarova M, Boueva A, Marinova S, Zlatanova G. Use of darbepoetin alfa (Aranesp®) for anemia treatment in children with chronic kidney disease – clinical experience of Bulgarian pediatric group. J of IMAB. 2017 Jan-Mar;23(1):1421-1426. DOI: 10.5272/jimab.2017231.1421.

Correspondence to: Maria Gaydarova, Depatment of nephrology and dialysis, University Pediatric Hospital, Sofia, Bulgaria; 11, Ivan Geshov blvd., Sofia, Bulgaria; E-mail: gaydarova@nephros.net

REFERENCES:
1. van der Putten K, Braam B, Jie KE, Gaillard CA. Mechanisms of disease: erythropoietin resistance in patients with both heart and kidney failure. Nat Clin Pract Nephrol. 2008 Jan;4(1):47-57. [PubMed]
2. van Damme-Lombartes R, Herman J. Erythropoetin treatment in children with renal failure. Pediatr Nephrol. 1999 Feb;13(2):148-152. [PubMed] [CrossRef]
3. Eschbach JW, Abdulhadi MH, Browne JK, Delano BG, Downing MR, Egrie JC, et al. Recombinant human erythropoietin in anemic patients with end-stage renal disease. Results of a phase III multicenter clinical trial. Ann Intern Med. 1989 Dec 15;111(12):992-1000. [PubMed]
4. Schaefer F, Hoppe B, Jungraithmayr T, Klaus G, Pape L, Farouk M, et al. Safety and usage of darbepoetin alfa in children with chronic kidney disease: prospective registry study. Pediatr Nephrol. 2016 Mar;31(3):443-53. [PubMed] [CrossRef]
5. Alsalimy N, Awaisu A. Methoxy polyethylene glycol-epoetin beta versus darbepoetin alfa for anemia in non-dialysis-dependent CKD: a systematic review. Int J Clin Pharm. 2014 Dec;36(6):1115-25. [PubMed] [CrossRef]
6. Hattori M, Uemura O, Hataya H, Ito S, Hisano M, Ohta T, et al. Efficacy and safety of darbepoetin alfa for anemia in children with chronic kidney disease: a multicenter prospective study in Japan. Clin Exp Nephrol. 2014 Aug;18(4):634-41. [PubMed] [CrossRef]
7. Aranesp®. Sumary of Product Characteristics. www.ema.europa.eu.
8. Imai E, Maruyama S, Nangaku M, Hirakata H, Hayashi T, Narita I, et al.Rationale and study design of a randomized controlled trial to assess the effects of maintaining hemoglobin levels using darbepoetin alfa on prevention of development of end-stage kidney disease in non-diabetic CKD patients (PREDICT Trial). Clin Exp Nephrol. 2016 Feb;20(1):71-6. [PubMed] [CrossRef]
9. Bernieh B, Abouchacra S, Boobes Y, Al Hakim MR, Nagelkerke N, Chaaban A, et al. Comparison between short- and long-acting erythropoiesis-stimulating agents in hemodialysis patients: target hemoglobin, variability, and outcome. Int Urol Nephrol. 2014 Feb;46(2):453-9. [PubMed] [CrossRef]
10. Lerner G, Kale AS, Warady BA, Jabs K, Bunchman TE, Heatherington A, et al. Pharmacokinetics of darbepoetin alfa in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2002 Nov;17(11):933-7. [PubMed]
11. Evans JH, Brocklebank JT, Bowmer CJ, Ng PC. Pharmacokinetics of recombinant human erythropoietin in children with renal failure. Nephrol Dial Transplant. 1991; 6(10):709-14. [PubMed]
12. De Palo T, Giordano M, Palumbo F, Bellantuono R, Messina G, Colella V, et al. Clinical experience with darbepoietin alfa (NESP) in children undergoing hemodialysis. Pediatr Nephrol. 2004 Mar;19(3):337-40.  [PubMed] [CrossRef]
13. Geary DF, Keating LE, Vigneux A, Stephens D, Hebert D, Harvey EA. Darbepoetin alfa (Aranesp) in children with chronic renal failure. Kidney Int. 2005 Oct;68(4):1759-65. [PubMed] [CrossRef]
14. Rijk Y, Raaijmakers R, van de Kar N, Schroder C. Intraperitoneal treatment with darbepoetin for children on peritoneal dialysis. Pediatr Nephrol. 2007 Mar;22(3):436-40. [PubMed] [CrossRef]
15. Warady BA, Arar MY, Lerner G, Nakanishi AM, Stehman-Breen C. Darbepoetin alfa for the treatment of anemia in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2006 Aug;21(8):1144-52. [PubMed]
16. Geary DF, Keating LE, Vigneux A, Stephens D, Hébert D, Harvey EA.  Darbepoetin alfa (Aranesp) in children with chronic renal failure. Kidney Int. 2005 Oct;68(4):1759-65. [PubMed]
17. Andre JL, Deschenes G, Boudailliez B, Broux F, Fischbach M, Gagnadoux MF, et al. Darbepoetin, effective treatment of anaemia in paediatric patients with chronic renal failure. Pediatr Nephrol. 2007 May;22(5):708-14. [PubMed]
18. Hattori M, Matsunaga A, Akioka Y, Fujinaga S, Nagai T, Uemura O, et al. Darbepoetin alfa for the treatment of anemia in children undergoing peritoneal dialysis: a multicenter prospective study in Japan. Clin Exp Nephrol. 2013 Aug;17(4):582-8. [PubMed] [CrossRef]
19. Jadoul M, Vanrenterghem Y, Foret M, Walker R, Gray SJ. Darbepoetin alfa administered once monthly maintains hemoglobin levels in stable dialysis patient. Nephrol Dial Transplant. 2004 Apr;19(4):898-903. [PubMed] .

Received: 10 November 2016
Published online: 17 January 2017

back to Online Journal