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Effect of Subcutaneous Methoxy Polyethylene Glycol-epoetin Beta on Anemia and Nutritional Indices in Peritoneal Dialysis Patients  

Kim, Kyung Sook (College of Pharmacy, Chungbuk National University)
Lee, Jun Seop (Department of Pharmacy, Chungbuk National University Hospital)
Kim, Hye-Young (Department of Internal Medicine, College of Medicine, Chungbuk National University)
Lee, Myung Koo (College of Pharmacy, Chungbuk National University)
Publication Information
Korean Journal of Clinical Pharmacy / v.22, no.3, 2012 , pp. 202-210 More about this Journal
Abstract
Methoxy polyethylene glycol-epoetin beta (MPG-EPO), a continuous erythropoietin receptor activator, is a new erythropoiesis-stimulating agent with a long half-life. The purpose of this prospective study is to assess the effects of once-monthly subcutaneous MPG-EPO on hematological responses and nutritional status in peritoneal dialysis patients. Forty four patients undergoing stable peritoneal dialysis were enrolled into the study. Darbepoetin alfa therapy, in peritoneal dialysis patients, was converted to the monthly administration of subcutaneous MPG-EPO for 6 months. The starting dose of MPG-EPO was based on the previous weekly dose of darbepoetin alfa. The dose adjustments were performed to maintain the hemoglobin (Hb) levels in a target range of 10.5-11.0 g/dL. If the Hb levels exceeded 11.0 g/dL, MPG-EPO was temporarily interrupted for 1 month. The mean Hb levels were stable with the values of $9.5{\pm}1.1$ g/dL at baseline, and $10.4{\pm}0.9$ g/dL at the 6th month after conversion. The mean differences in the changes of Hb levels between the baseline and the 6th month were $0.9{\pm}1.4$ g/dL, which was statistically significant. However, the mean differences of iron, transferrin saturation and ferritin concentrations were not significant. It did not show significant differences in the changes of the nutritional parameters. These results suggest that the once-monthly subcutaneous administration of MPG-EPO for 6 months effectively maintains the Hb levels and nutritional status in peritoneal dialysis patients. Taken together, the once-monthly subcutaneous administration of MPG-EPO was practical and might improve the clinical compliance for the management of renal anemia in peritoneal dialysis patients.
Keywords
erythropoietin; methoxy polyethylene glycol-epoetin beta; anemia; nutrition; peritoneal dialysis patients;
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