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NDT Advance Access published online on August 5, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl386
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 16, 2006
Accepted June 8, 2006

Original Article

Effectiveness of weekly darbepoetin alfa in the treatment of anaemia of HIV-infected haemodialysis patients

Carlos Lucas 1, Fernando Carrera 2 *, Cristina Jorge 1, Helena Boquinhas 1, and Maria Joao Pais 1

1 Department of Nephrology, Hospital de Santa Cruz, Carnaxide, Leiria, Portugal
2 Dialysis Unit, Eurodial, Leiria, Portugal

* To whom correspondence should be addressed.
Fernando Carrera, E-mail: fcarrera{at}mail.telepac.pt



  Abstract

Background. Anaemia is aggravated by the coexistence of chronic kidney disease (CKD) in patients infected with human immunodeficiency virus (HIV). Darbepoetin alfa effectively alleviates CKD-associated anaemia with less frequent dosing than recombinant human erythropoietin (EPO). The current study aimed to determine the efficacy, safety and cost-effectiveness of darbepoetin alfa compared with erythropoietin alfa (EPO-alfa) for treatment of anaemia in HIV-infected subjects receiving haemodialysis.

Methods. An open label, single arm, prospective study of 12 haemodialysis subjects with HIV infection was conducted for a duration of 6 months after switching from intravenous (i.v.) EPO-alfa two/three times weekly to i.v. darbepoetin alfa once weekly. The primary end point was the proportion of patients maintaining haemoglobin (Hb) levels ≥11 g/dl while a weekly dose of darbepoetin alfa was a secondary end point.

Results. Darbepoetin alfa, as effectively as EPO-alfa maintained the proportion of the subjects having Hb levels ≥11 g/dl at an average weekly dose of 40.60 µg compared with an equivalent dose of 51.84 µg for EPO-alfa. Antiretroviral therapy and HIV infection stage remained the same for each specific patient throughout the study period, including the last 6 months of EPO-alfa therapy. No difference in the incidence of adverse effects was observed after switching from EPO-alfa to darbepoietin alfa.

Conclusions. Lower doses of darbepoetin alfa at extended dosing interval is as safe and effective as EPO-alfa for treating anaemia, suggesting that darbepoetin alfa is a more cost-effective therapeutic alternative to EPO-alfa in the management of anaemia associated with HIV infection in subjects receiving haemodialysis.

Keywords: anaemia; chronic kidney disease; darbepoetin alfa; erythropoietin alfa; human erythropoietin; human immunodeficiency virus.

The results presented in this manuscript have been published previously in outline, as a poster, at the ERA-EDTA XLI Congress held in Lisbon from May 15 to 18, 2004.


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