Anemia of
chronic kidney disease (CKD) is common, yet it is often under-recognized and undertreated, with serious adverse consequences. It is highly responsive to treatment with
erythropoiesis-stimulating agents (ESAs).
Darbepoetin alfa is a hyperglycosylated ESA that has a lower affinity to the
erythropoietin receptor but a longer half-life than recombinant human
erythropoietin, irrespective of administration by a subcutaneous or intravenous route. Owing to its pharmacokinetic characteristics,
darbepoetin alfa has been used in extended dosing intervals ranging from once every week to once every 4 weeks in CKD patients on dialysis, as well as in CKD patients not on dialysis.
Darbepoetin alfa has been shown to be safe and effective in clinical trials. The safety profile of
darbepoetin alfa is similar to that of recombinant human
erythropoietin. While target
hemoglobin levels in CKD
anemia remain debatable, treatment of
anemia with ESAs has the proven benefits of reducing transfusions and improving quality of life.
Darbepoetin alfa has the potential to simplify the treatment of CKD
anemia with many advantages, including infrequent dosing, improved patient convenience and compliance, and decreased healthcare resource utilization.