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首页> 外文期刊>Current therapeutic research, clinical and experimental. >A Safe and Easy Introduction of Darbepoetin-Alpha in Patients Receiving Maintenance Hemodialysis and Epoetin Monotherapy: A 'Half-and-Half' Combination Therapy
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A Safe and Easy Introduction of Darbepoetin-Alpha in Patients Receiving Maintenance Hemodialysis and Epoetin Monotherapy: A 'Half-and-Half' Combination Therapy

机译：在接受维持性血液透析和依泊汀单药治疗的患者中安全简单地引入达比泊汀-α：“半数半联合疗法”

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Background: In hemodialysis (HD) patients requiring anemia management, the 3-fold longer terminal half-life (25.3 hours) of darbepoetin-alpha (DA) results in reduced dose frequency when compared with recombinant human erythropoietin (EPO) -alpha or -beta by intravenous administration (8.5 hours). However, this might become a disadvantage in the face of rapid withdrawal of the drug against hemoglobin (Hb) overshoot and/or cycling.Objective: A "half-and-half combination therapy of DA and EPO was used to avoid a possible Hb overshoot due to the full conversion from EPO to DA. Methods: Thirty-two stable patients receiving HD (13 men, 19 women) and EPO monotherapy were enrolled and prospectively followed for 9 months. The mean (SD) patient age was 63.2 (11.3) years. The HD duration was 10.7 (8.2) years. The DA doses (in micrograms) of 1/200 of halves of previous weekly EPO doses (in international units) were given intravenously on the second HD day of a week. The remaining half doses of previous weekly EPO doses were dividedly administered intravenously on the first and the third HD days of the week. The target Hb was 11 g/dL Results: The "half-and-half combination with DA and EPO resulted in no episodes of Hb overshoot. The Hb values did not exceed 13 g/dL throughout the follow-up period. The mean (SD) dose of 3984 (2175) IU/wk EPO was converted to a combination of 1688 (894) IU/wk EPO and 13.4 (7.9) ug/wk DA at baseline. Thereafter, the mean (SD) doses became 304 (656) IU/wk EPO and 16.0 (8.4) ug/wk DA at 3 months, and 532 (912) IU/wk and 15.8 (9.0) ug/wk, respectively, at 9 months. The total combination doses of DA/EPO (as EPO equivalents) were significantly reduced to 80% to 84% of the original EPO doses after 2 months of introduction of the DA/EPO combination. Conclusions: A "half-and-half combination therapy may be a safe and easy method to merge DA into EPO monotherapy without Hb overshoot or dramatic cycling.
机译：背景：在需要贫血治疗的血液透析（HD）患者中，与重组人促红细胞生成素（EPO）-α或-相比，达比泊汀-α（DA）的末端半衰期延长了3倍（25.3小时），导致剂量频率降低。静脉给药（8.5小时）。但是，面对快速停止服用抗血红蛋白（Hb）过量和/或循环的药物，这可能会成为不利因素。目的：“ DA和EPO的半联合疗法用于避免可能的Hb过量方法：招募了32例接受HD治疗的稳定患者（男13例，女19例），均接受EPO单一疗法，预期随访9个月，平均（SD）患者年龄为63.2（11.3）。 HD持续时间为10.7（8.2）年，每周HD的第二天静脉注射以前每周EPO剂量（国际单位）一半的1/200的DA剂量（以微克为单位）。在每周的HD的第1天和第3天，将先前每周一次的EPO剂量静脉内分次给药。目标Hb为11 g / dL结果：“ DA和EPO的一半和一半的结合不会导致Hb发作超调。在整个随访期间，Hb值不超过13 g / dL。在基线时，将3984（2175）IU / wk EPO的平均（SD）剂量转换为1688（894）IU / wk EPO和13.4（7.9）ug / wk DA的组合。此后，在3个月时的平均（SD）剂量分别为304（656）IU / wk EPO和16.0（8.4）ug / wk DA，在5个月时分别为532（912）IU / wk和15.8（9.0）ug / wk。 9个月。引入DA / EPO组合2个月后，DA / EPO的总组合剂量（以EPO当量计）显着降低至原始EPO剂量的80％至84％。结论：“半联合疗法可能是将DA合并为EPO单一疗法而又没有Hb超调或剧烈循环的安全，简便方法。

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