Darbepoetin-α more advantageous than recombinant human erythropoietin to improve anemia in hemodialysis patients

A recent study suggests that darbepoetin-α (DPO-α) is more advantageous than recombinant human erythropoietin (rHuEPO) in improving anemia in hemodialysis (HD) patients. This study was published in the European Journal of Haematology.

This study included a long-term crossover study for 3 years to compare the effects of the two erythropoiesis-stimulating agents (ESA) on serum iron, transferrin saturation (TSAT), and ferritin, as well as a short-term crossover study for 8 weeks to examine their effects on serum hepcidin-25 in HD patients.

From the long-term crossover study, it was demonstrated that the change of ESA from rHuEPO to DPO-α significantly decreased serum ferritin while serum iron and TSAT remained unchanged. On the other hand, DPO-α as well as rHuEPO maintained hemoglobin levels between 10.0 and 11.0 g/dL, which was the target range. In the short-term crossover study, area under the percent suppression of serum hepcidin-25 time curve for the first 7 days during the DPO-α treatment period was significantly greater than that during the rHuEPO period. Also, the greater suppression of hepcidin-25 by DPO-α may facilitate iron mobilization, resulting in a diminution of body iron stores without any significant effect on serum iron utilizable for erythropoiesis.

From the above results, it can be concluded that DPO-α has a greater advantage than rHuEPO in that it facilitates iron mobilization from body stores into the bone marrow to induce effective erythropoiesis.