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Toru Kawai, Yoshie Kusano, Kyouko Yamada, Chikako Ueda, Atsushi Kawai, Takao Masaki
Recent evidence on maintenance administration of epoetin beta pegol, a continuous erythropoiesis receptor activator (CERA), in dialysis patients shows the clinical benefit of bi-weekly administration (Q2W) in improving hematopoiesis and iron use efficiency. We undertook a single-center observational study of 33 Japanese maintenance dialysis patients, whose anemia had been kept stable through weekly administration (Q1W) of darbepoetin (DA), to evaluate the effectiveness of CERA Q2W switched from DA in maintaining hemoglobin (Hb) levels over a 12-month period...
November 14, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Douglas S Fuller, Bruce M Robinson, Francesco Locatelli, Ronald L Pisoni
BACKGROUND: Clinicians providing dialysis care have numerous erythropoiesis-stimulating agents (ESAs) available for treating anemia. We sought to provide a contemporary description of ESA types used in hemodialysis (HD) settings in nine European countries. METHODS: Our study uses Dialysis Outcomes and Practice Patterns Study phase 5 (2012-2015) data from nine European countries (Belgium, France, -Germany, Italy, Russia, Spain, Sweden, Turkey, and the United Kingdom)...
2018: Nephron
Kazuya Takasawa, Chikako Takaeda, Takashi Wada, Norishi Ueda
Background: We determined optimal serum ferritin for oral iron therapy (OIT) in hemodialysis (HD) patients with iron deficiency anemia (IDA)/minor inflammation, and benefit of intravenous iron therapy (IIT) for OIT-nonresponders. Methods: Inclusion criteria were IDA (Hb <120 g/L, serum ferritin <227.4 pmol/L). Exclusion criteria were inflammation (C-reactive protein (CRP) ≥ 5 mg/L), bleeding, or cancer. IIT was withheld >3 months before the study. ΔHb ≥ 20 g/L above baseline or maintaining target Hb (tHB; 120-130 g/L) was considered responsive...
March 29, 2018: Nutrients
Tadashi Yoshida, Matsuhiko Hayashi
Anemia in chronic kidney disease (CKD) is a risk factor for cardiovascular diseases and is treated by long-acting erythropoiesis-stimulating agents (ESAs). Although the results of previous studies have shown that hemoglobin levels could not be maintained at the initiation of dialysis in CKD patients treated with recombinant human erythropoietin, it remains undetermined whether long-acting ESAs are effective in preventing the progression of anemia at the initiation of dialysis. In the present study, hemoglobin levels in 40 CKD patients treated with darbepoetin alfa (DA) and 15 CKD patients treated with a continuous erythropoietin receptor activator (CERA) were retrospectively compared during the 6 months period before the initiation of dialysis...
September 26, 2017: Keio Journal of Medicine
Wen-Sheng Liu, Hsiang-Lin Chan, Yen-Ting Lai, Ya-Hsu Yang, Hao-Wei Teng, Chih-Kuang Liu, Szu-Yuan Li, Chih-Yu Yang, Tsung-Yun Liu, Chih-Ching Lin
OBJECTIVE: The response of erythropoietic stimulating agents (ESA) in uremic patients may be associated with the changes of biochemical parameters, metal elements and inflammation status during the shift from one ESA to another. METHOD: We compared changes in above mentioned factors after switching from darbepoetin-α (DPO) 20μg weekly for 10 weeks to continuous erythropoietin receptor activator (CERA) 100μg monthly for 10 weeks in uremic patients on hemodialysis...
July 2016: Environmental Toxicology and Pharmacology
Hirokazu Honda, Yasuna Kobayashi, Shoko Onuma, Keigo Shibagaki, Toshitaka Yuza, Keiichi Hirao, Toshinori Yamamoto, Naohisa Tomosugi, Takanori Shibata
BACKGROUND: We aimed to identify associations between erythroferrone (ERFE), a regulator of hepcidin 25, and biomarkers of erythropoiesis and iron metabolism. We also aimed to determine the effects of erythropoiesis-stimulating agents (ESA), continuous erythropoietin receptor activator (CERA) and darbepoetin-α (DA) on ERFE production in patients on hemodialysis (HD). METHODS: Blood samples were obtained from 59 patients before HD sessions on day 0 (baseline). Twenty patients who were injected with either CERA (N = 10) or DA (N = 10) at the end of the dialysis week (day 0), who had ferritin ≥ 100 ng/mL and/or transferrin saturation ≥ 20%, and hemoglobin > 9 g/dL were selected from among the 59 patients...
2016: PloS One
Omar Maoujoud, Samir Ahid, Yahia Cherrah
OBJECTIVE: The purpose of this study was to determine the cost-utility of treating anemic dialysis patients with continuous erythropoietin receptor activator (CERA) once monthly or Epoetin Beta (EpoB) thrice weekly compared with a reference strategy of managing anemia with red blood cell transfusion (RBCT). METHODS: Cost-utility analysis study design. Decision analysis model, National health care payer, over 1 year with the publicly funded health care system. Chronic hemodialysis patients with renal anemia were included...
2016: International Journal of Nephrology and Renovascular Disease
Shoko Onuma, Hirokazu Honda, Yasuna Kobayashi, Toshinori Yamamoto, Tetsuo Michihata, Keigo Shibagaki, Toshitaka Yuza, Keiichi Hirao, Naohisa Tomosugi, Takanori Shibata
Continuous erythropoietin receptor activator (CERA) and darbepoetin-α (DA) might differently affect iron metabolism and erythropoiesis in patients on hemodialysis (HD). This prospective study examined a cohort of patients on HD who had received either intravenous CERA every 2 or 4 weeks (N = 25) or DA once each week (N = 47). Blood was sampled before HD sessions on days 0, 2, 4, 7 and 14, and on days 0, 3, 5, 7 and 14 from patients who were injected with ESA at the beginning and end of the dialysis week, respectively...
December 2015: Therapeutic Apheresis and Dialysis
J Rieger, T Krummel, P Petitjean, F Chantrel, Y Dimitrov
In early 2012, due to national supply disruption, the methoxy-polyethylene glycol-epoetin beta (CERA) was no longer available and has been replaced by darbepoetin alfa (DA) in all dialysis patients. Official recommendations for the replacement of one by the other is missing or unclear. On this occasion, we wanted to examine how the shift from CERA to DA was done in terms of dose conversion factor and the other factors that could have influenced the dose of DA prescribed (hemoglobin, patient weight, dose of CERA)...
January 2016: Annales Pharmaceutiques Françaises
Mariam Ezziani, Adil Najdi, Souad Mikou, Hakim Hanin, Mohammed Arrayhani, Tarik Sqalli Houssaini
No abstract text is available yet for this article.
2015: Pan African Medical Journal
Guido Bellinghieri, Carmela Giuseppina Condemi, Salvatore Saitta, Gianluca Trifirò, Sebastiano Gangemi, Vincenzo Savica, Michele Buemi, Domenico Santoro
Hypo-responsiveness to erythropoiesis-stimulating agents (ESAs) has been associated with increased mortality in end-stage renal disease patients. It is not clear if this effect is related to the elevated ESAs dosage for targeting hemoglobin levels or underlying morbid conditions that lead to ESA resistance. We retrospectively evaluated from 2008 to death or December 2011, 28 consecutive incident hemodialysis patients. We identified 2 cohort of patients based on their mean annual ESAs dosage. The correlation between data was evaluated with the Spearman's rho test...
March 2015: Journal of Renal Nutrition
Tatsunori Toida, Yuji Sato, Norihiko Shibata, Kazuo Kitamura, Shouichi Fujimoto
BACKGROUND/AIMS: We investigated the method of switching EPO to CERA that does not cause a decrease in the Hb level. METHODS: Fifty EPO-treated patients were randomly divided into two groups in which CERA was administered every two weeks (Q2W) or every four weeks (Q4W). After 8 weeks of treatment, the frequency of administration was changed to Q4W in the former. Follow-up was performed for 24 weeks. RESULTS: There was no difference in the Hb level between the two groups until 6 weeks...
2014: Blood Purification
Yuki Morikami, Akira Fujimori, Shioko Okada, Mai Kumei, Noriko Mizobuchi, Makoto Sakai
Epoetin beta pegol is a continuous erythropoietin receptor activator (CERA) with a long half-life. Although CERA has been shown to maintain adequate hemoglobin (Hb) levels at prolonged dosing intervals, the optimal dosing schedule remains unclear. We therefore compared the efficacy of maintaining hemoglobin levels with administration of twice-monthly CERA (TWICE) versus once-monthly CERA (ONCE). Twenty hemodialysis patients receiving epoetin beta (EPO) were enrolled in this crossover study. Patients were assigned to either the TWICE or the ONCE group based on matching Hb levels and EPO doses...
April 2015: Therapeutic Apheresis and Dialysis
Tadashi Kuji, Yoshiyuki Toya, Tetsuya Fujikawa, Midori Kakimoto-Shino, Masahiro Nishihara, Kazuhiko Shibata, Kouichi Tamura, Nobuhito Hirawa, Hidehisa Satta, Sei-ichi Kawata, Naoaki Kouguchi, Satoshi Umemura
This study aimed to evaluate the effect of different timings of iron administration during erythropoiesis activated by continuous erythropoietin receptor activator (CERA) on reticulocyte iron uptake in hemodialysis patients. In total, 110 patients were randomized to receive 40 mg intravenous elemental iron doses at all three hemodialysis sessions in the first week (IW1 group: n = 57) or in the third week (IW3 group: n = 53) after CERA administration. Following CERA administration at day 0, reticulocyte count increased, peaking at day 7...
April 2015: Therapeutic Apheresis and Dialysis
Fadwa Saqr Al-Ali, Mohamed El-Sayed Abdelfattah, Ashraf Ahmed Fawzy, Ahmed Farouk Hamdy, Aisha Elsayed Abdulla
Despite extensive use, to the best of our knowledge, no trial has simultaneously compared the three currently used erythropoietin-stimulating agents (ESAs) in a prospective manner in the treatment of anemia of end-stage renal disease patients. All hemodialysis patients in Qatar who were treated with short-acting epoetin alfa or beta have been screened. Eligible patients had been prospectively randomized, either to continue on the previous regimen of epoetin or to receive darbepoetin alfa or continuous erythropoietin receptor activator (CERA) for a total period of 40 weeks...
January 2015: Hemodialysis International
Yuki Morikami, Akira Fujimori, Shioko Okada, Mai Kumei, Noriko Mizobuchi, Makoto Sakai
Epoetin beta pegol (a continuous erythropoietin receptor activator; CERA) is usually administered once in 4 weeks or once monthly. However, the optimal dosing interval remains unknown. We, therefore, compared the effect of CERA administration between dosing intervals of 2 weeks (TWICE group) and 4 weeks (ONCE group) on erythropoiesis and iron metabolism in 20 hemodialysis patients. CERA was administered intravenously at weeks 0 and 2 for the TWICE group, and at week 0 for the ONCE group. Levels of hemoglobin (Hb), reticulocyte count, ferritin, transferrin saturation, content of Hb in reticulocytes and hepcidin-25 were monitored weekly for 4 weeks...
October 2014: Therapeutic Apheresis and Dialysis
Midori Kakimoto-Shino, Yoshiyuki Toya, Tadashi Kuji, Tetsuya Fujikawa, Satoshi Umemura
Inadequate iron availability limits the response to erythropoiesis-stimulating agents (ESA) and hepcidin is a key regulator of iron metabolism. However, there is little information concerning time-dependent changes in hepcidin in response to the change of accelerated iron demand due to ESA-induced erythropoiesis. In this study, iron-related parameters, including hepcidin levels, were explored in comparison to patients receiving continuous erythropoietin receptor activator (CERA) and epoetin beta (EPO) treatment...
October 2014: Therapeutic Apheresis and Dialysis
Jieun Oh, Kwon-Wook Joo, Ho-Jun Chin, Dong-Wan Chae, Sung-Gyun Kim, Soo Jin Kim, Wookyung Chung, Sejoong Kim, Wooseong Huh, Ha Young Oh, Bum Soon Choi, Chul-Woo Yang, Suhnggwon Kim
Continuous erythropoietin receptor activator (CERA) is an erythropoietin with a long-half life. This study investigated the efficacy of CERA for correcting anemia in Korean patients on dialysis. Patients (≥ 18 yr) who were not receiving any ESAs for more than 8 weeks were randomly assigned to either intravenous CERA once every 2 weeks (n=39) or epoetin beta thrice-weekly (n=41) during a 24-week correction phase. Hemoglobin (Hb) response was defined as increase of Hb by at least 1 g/dL and Hb ≥ 11 g/dL without red blood cell (RBC) transfusion...
January 2014: Journal of Korean Medical Science
Takayuki Hirai, Yoshiko Nishizawa, Hiroshi Nakazono, Mariko Asai, Hideki Yamashita, Ayako Sasaki, Tetsumasa Yamashita, Kazuomi Yamashita, Kenichiro Shigemoto, Satoru Harada, Sonoo Mizuiri
Methoxy polyethylene glycol-epoetin beta, a continuous erythropoietin receptor activator (CERA), is reported to be effective in managing renal anemia but there is little data about CERA in Japan. This study aimed to ascertain the effects of CERA in Japanese hemodialysis patients and the appropriate starting dose of CERA when switching from other erythropoiesis-stimulating agents. We switched 61 stable hemodialysis patients to 4-weekly intravenous CERA, from either epoetin beta (rHuEPO) or darbepoetin alpha (DA)...
October 2013: Therapeutic Apheresis and Dialysis
Ita Jelić, Vesna Lovcić, Ivana Kurtović, Marija Josipović, Zana Havranek, Lana Kostić, Sanjin Racki
INTRODUCTION: Anemia is a well-documented consequence of chronic kidney disease, its frequency increases with the progression of renal failure and occurs in up to 95% of patients with end stage renal disease (ESRD). Erythropoietin stimulating agents (ESAs) have become the standard of care in the treatment of renal anemia. The use of methoxy polyethylene glycol-epoetin beta, continuous erythropoietin receptor activator, represents an important benefit in clinical practice. AIM: The aim of the OPATIJA study was to compare the efficacy and safety of maintaining hemoglobin levels in dialysis patients and to assess its variability in a parallel-group design...
July 2012: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
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