Abstract
In patients with end-stage renal disease, renal anemia develops as a result of erythropoietin deficiency. Recombinant human erythropoietin (rHuEPO) has been widely prescribed to treat renal anemia. Darbepoetin, which is an analogue of rHuEPO with an increased terminal half-life, has been approved in Japan since July 2007. We performed a prospective study to compare Hb-maintenance dose and cost effectiveness between darbepoetin and rHuEPO in hemodialysis patients for 18 weeks. Our cohort comprised 77 patients who were undergoing maintenance hemodialysis 3 times per week in Suzuki-Nephro Clinic. The patients were divided into two groups. Thirty-nine patients were assigned to receive rHuEPO 750IU/HD and 39 patients were assigned darbepoetin 15μg/week as Hb-maintenance dose to maintain a target Hb level of 10.0 to 11.4g/dL, respectively. At 18 weeks, the mean Hb level of darbepoetin group was significantly higher than that of rHuEPO group. The proportion of patients whose Hb level exceeded target Hb level was significantly higher in the darbepoetin group than rHuEPO group. Although final Hb level was higher in darbepoetin group than that of rHuEPO group, the cost was lower in the darbepoetin group than in the rHuEPO group, indicating that darbepoetin was definitely superior to rHuEPO in cost effectiveness. The present results suggests that the dose of darbepoetin 15μg/week is high as a regular dose to maintain the target Hb level in hemodialysis patients and it may be necessary to reduce the dose to less than 15μg/week.
