만성신부전 환자의 빈혈 치료 시 기존 erythropoietin에서methoxy polyethylene glycol-epoetin-β로의 초기 전환용량 평가
Evaluation of Initial Conversion Dose of Methoxy Polyethylene Glycol-epoetin-βin Chronic Renal Failure Patients
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Erythropoiesis stimulating agents(ESA) correct renal anemia in a chronic kidney disease(CKD). The MIRCERA(Methoxy polyethylene glycol-epoetin-β, PEG-EPO) is ESA with prolongedhalf-life and less dosing frequency. The manufacturer recommends the PEG-EPO withinitial conversion dose of 120 mcg, 200 mcg or 360 mcg once per month on previous ESA dose. But there have been patients with lower initial conversion doses. We evaluate the efficacy ofconverting previous ESA to PEG-EPO at doses lower than the recommended. We review the electronicmedical record data of CKD patients who used PEG-EPO initially in lower conversion doseon previous ESA in Seoul St. Mary’s Hospital between the period of May 23, 2011 and July 22,2011. The primary outcomes are the changes of average hemoglobin(Hgb), hematocrit(Hct) levelsand Hgb response rates before and after the switch from previous ESA to PEG-EPO. As a result, the studied patients(n=34) shift between the PEG-EPO 50 mcg(n=4) or 75 mcg(n=30). The averagePEG-EPO dose is 83.6±45.0 mcg/month for three months. The average Hgb is 9.67±0.96 mg/dLbefore and 10.08±1.04 mg/dL after the switch of medication(p=0.024). Hgb response rates(10 -<13 g/dL) increase from 41.2% to 61.8%, but not significantly(p=0.089). Therefore, PEG-EPO canbe efficaciously used at lower conversion doses than as prescribed on the information. However,further prospective, randomized controlled studies are necessary in the future.
Abstract
Erythropoiesis stimulating agents(ESA) correct renal anemia in a chronic kidney disease(CKD). The MIRCERA(Methoxy polyethylene glycol-epoetin-β, PEG-EPO) is ESA with prolongedhalf-life and less dosing frequency. The manufacturer recommends the PEG-EPO withinitial conversion dose of 120 mcg, 200 mcg or 360 mcg once per month on previous ESA dose. But there have been patients with lower initial conversion doses. We evaluate the efficacy ofconverting previous ESA to PEG-EPO at doses lower than the recommended. We review the electronicmedical record data of CKD patients who used PEG-EPO initially in lower conversion doseon previous ESA in Seoul St. Mary’s Hospital between the period of May 23, 2011 and July 22,2011. The primary outcomes are the changes of average hemoglobin(Hgb), hematocrit(Hct) levelsand Hgb response rates before and after the switch from previous ESA to PEG-EPO. As a result, the studied patients(n=34) shift between the PEG-EPO 50 mcg(n=4) or 75 mcg(n=30). The averagePEG-EPO dose is 83.6±45.0 mcg/month for three months. The average Hgb is 9.67±0.96 mg/dLbefore and 10.08±1.04 mg/dL after the switch of medication(p=0.024). Hgb response rates(10 -<13 g/dL) increase from 41.2% to 61.8%, but not significantly(p=0.089). Therefore, PEG-EPO canbe efficaciously used at lower conversion doses than as prescribed on the information. However,further prospective, randomized controlled studies are necessary in the future.
참고문헌 (15)
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