Erythropoiesis Stimulating Agents for Anemia Management in Egyptian Hemodialysis Patients
Study Details
Study Description
Brief Summary
This observational study aims to compare long-acting darbepoetin alpha versus short-acting epoetin alpha erythropoietin-stimulating agents in Egyptian hemodialysis patients. The main questions aim to answer are:
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What are the effectiveness and safety of long- acting versus short-acting erythropoietin-stimulating agents in Egyptian hemodialysis patients?
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What is the cost-effectiveness of long- acting versus short-acting erythropoietin-stimulating agents in Egyptian hemodialysis patients?
Participants will be divided into 2 groups; epoetin alfa (short-acting ESA), Eprex group, and darbepoetin alfa (long-acting ESA), Aranesp group for six month study period.
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
Anemia, the most prevalent and dangerous complication of chronic kidney disease, is caused when the kidney is unable to produce enough erythropoietin to promote the creation of red blood cells (CKD). Anemia from CKD is linked to higher mortality, cardiovascular disease, exhaustion, dyspnea, and a lower quality of life for patients.
It has been demonstrated that using erythropoietin-stimulating drugs (ESAs) in treating renal anemia increases survival, lowers cardiovascular morbidity, and improves the quality of life.
Epoetin alfa (EPO), an ESA with a shorter half-life, and darbepoetin alfa (DPO), are the two ESAs used in hemodialysis centers the most frequently in Egypt (longer half life ) Epoetin alfa is dosed one to three times per week, whereas darbepoetin alfa is dosed once per week or every two weeks.
Compared to epoetins, darbepoetin alfa's extended dose interval may benefit patients and their medical professionals.
Despite the fact that ESAs save CKD patients from needing blood transfusions, clinical trials, meta-analyses, and mortality hazards with ESAs targeting high hemoglobin levels have been shown. A higher ESA dose may be linked to cardiovascular problems and all-cause mortality independent of hemoglobin level.
Darbepoetin alfa has a lower risk of side effects because it only requires 35% of the dosage of epoetin alfa to attain the same target hemoglobin level. Darbepoetin alfa also has an advantage over epoetin alfa in that it makes it easier for the body to mobilize iron into the bone marrow to cause successful erythropoiesis, which may shield the body from any potential negative effects from having too much iron stored there. Despite this, the medication that Egyptian hemodialysis centers use the most is (EPO). This study compares (DPO) and (EPO) to determine which should be utilized based on efficacy, safety, and cost.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Aranesp group Aranesp group: patients received darbepoetin alpha prefilled syringe subcutaneously once weekly or biweekly |
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Eprex group Eprex group: patients received epoetin alpha prefilled syringe subcutaneously one to three times per week |
Outcome Measures
Primary Outcome Measures
- Percentage of patients reaching the target Hemoglobin in each group. [baseline to six months]
Assess the percentage of patients reaching the target Hemoglobin (10-11.5 g/dl) in each group during the study period.
Secondary Outcome Measures
- Analyze the cost-effectiveness of long-acting (DPO) versus short-acting (EPO) erythropoietin-stimulating agents in hemodialysis patients. [baseline to six months]
Determine which of the 2 regimen groups is the cost-saving regimen by the cost-effectiveness analysis to examine both the costs and health outcomes of long-acting (DPO) versus short-acting (EPO) erythropoietin-stimulating agents in hemodialysis patients.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients who have been stable and undergoing hemodialysis three times per week for at least three months
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Age must be 18 or older
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Patients who had been receiving a single form of ESA treatment for at least three months before the study's launch.
Exclusion Criteria:
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altered the type of ESA therapy; 2) underwent significant surgery; or (3) received RBC transfusions
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failed to adhere to dialysis therapy, as shown by missing more than two appointments each month.
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have COVID-19 infection.
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had cancer.
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underwent a kidney transplant
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were pregnant or nursing mothers
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were not followed up for the full six-month research period.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | the Memorial Souad Kafafi University Hospital | Giza | Egypt |
Sponsors and Collaborators
- Helwan University
Investigators
- Principal Investigator: Abdel-Hameed Ibrahim Ebid, Professor, Faculty of Pharmacy, Helwan University
- Study Director: Amira Mohamed El-Sawy, Lecturer, Faculty of Pharmacy, Helwan University
- Study Director: Hazem Ayoub, Lecturer, Faculty of Medicine, Al Azhar University
Study Documents (Full-Text)
None provided.More Information
Publications
- Bernieh B, Abouchacra S, Boobes Y, Al Hakim MR, Nagelkerke N, Chaaban A, Ahmed M, Hussain Q, Jack HE, Abayechi F, Khan I, Gebran N. Comparison between short- and long-acting erythropoiesis-stimulating agents in hemodialysis patients: target hemoglobin, variability, and outcome. Int Urol Nephrol. 2014 Feb;46(2):453-9. doi: 10.1007/s11255-013-0640-7. Epub 2014 Jan 22.
- Biggar P, Ketteler M, Hennemann H, Domling R. Switch of ESA therapy from darbepoetin-alpha to epoetin-beta in hemodialysis patients: a single-center experience. Clin Nephrol. 2008 Mar;69(3):185-92. doi: 10.5414/cnp69185.
- Chen N, Xing C, Niu J, Liu B, Fu J, Zhao J, Ni Z, Wang M, Liu W, Zhao J, Zhong L, Wu X, Li W, Chen Y, Shi W, Chen J, Yin A, Fu P, Wang R, Jiang G, Hou F, Ding G, Chen J, Xu G, Kondo Y, Su Y, Mei C. Darbepoetin alfa injection versus epoetin alfa injection for treating anemia of Chinese hemodialysis patients with chronic kidney failure: A randomized, open-label, parallel-group, non-inferiority Phase III trail. Chronic Dis Transl Med. 2022 Mar 29;8(1):59-70. doi: 10.1002/cdt3.13. eCollection 2022 Mar.
- Sinha SD, Bandi VK, Bheemareddy BR, Thakur P, Chary S, Mehta K, Pinnamareddy VR, Pandey R, Sreepada S, Durugkar S. Efficacy, tolerability and safety of darbepoetin alfa injection for the treatment of anemia associated with chronic kidney disease (CKD) undergoing dialysis: a randomized, phase-III trial. BMC Nephrol. 2019 Mar 13;20(1):90. doi: 10.1186/s12882-019-1209-1. Erratum In: BMC Nephrol. 2019 Nov 19;20(1):415.
- Anemia in CKD