혈액투석 환자의 빈혈치료에 있어 epoetin alfa와 darbepoetin alfa의 비교 연구

Abstract

Anemia is a common complication in chronic kidney disease (CKD) patients. As erythropoiesis- stimulating agents, Epoetin alfa (EPO) and darbepoetin alfa (DARB) are used to treatment of anemia in CKD patients. Especially, DARB has three times of half-time compare with EPO. The purpose of this study is to estimate the efficacy of EPO and DARB for treatment of anemia in hemodialysis patients. Data were collected retrospectively from patients who have been received hemodialysis in Asan Medical Center between January 1, 2002 and June 30, 2006. Eligible patients were 18 years of age or older and baseline Hb≤11g/dL. End points were the change of Hb level in 4, 8, 12 weeks from baseline, Hb response rate, and drug cost of EPO and DARB. Both all dose and common dose (EPO: 4000U/TIW, DARB: 60mcg/QW), the mean change in Hb level from baseline to 4, 8, 12 weeks was larger with EPO than DARB, but not significantly different(p>0.05). Combination therapy with iron supplementation, the mean change in Hb level was significantly larger with EPO than with DARB at 4 weeks (p<0.01). Hb response rate (≥11g/dL) was more common with EPO than DARB, while drug cost was higher for DARB than EPO. The mean changes in Hb level with EPO and DARB were not significantly different except for combination therapy with iron supplementation. Therefore when choosing drugs, considering merits and demerits of two drugs or patient's condition will be desirable.