Dose reduction conversion from epoetin to darbepoetin alfa in patients undergoing dialysis

According to a recent study conducted in patients undergoing dialysis, a dose reduction conversion from epoetin to darbepoetin alfa using the starting dose conversion of 200:1, helped achieve a 30% dose savings. This study was published in the journal, NDT Plus.

This meta-analysis was done after sourcing articles from Medline and EmBase in order to find out all published trials investigating Erythropoiesis-stimulating agents (ESAs) for treatment in anaemic patients receiving dialysis. Prospective randomized controlled, non-randomized and observational studies that included patients on dialysis and which compared epoetin and darbepoetin alfa dosing were selected. Out of 573 articles, 9 studies fulfilled the eligibility criteria and were included in the analysis. Target haemoglobin levels were maintained before and after conversion in all the studies.

From the meta-analysis, it was found out that overall percentage dose savings attained was 30% when dialysis patients were converted from epoetin to darbepoetin alfa. Intravenous administration (33%) showed greater dose savings when compared to subcutaneous (27%) and between switch-over studies (31%) and RCTs (27%).

Based on the findings, it can be concluded that using an initial 200:1 conversion ratio, as indicated by the European Medicines Agency, after conversion from epoetin to darbepoetin alfa, an average 30% dose savings could be achieved through subsequent reduction in dose.