Fewer dose changes with once-monthly C.E.R.A. in patients with chronic kidney disease

Background: Frequent dosing and requirements for dose adjustments of erythropoiesis-stimulating agents (ESAs) create significant burdens for healthcare providers and have been associated with hemoglobin (Hb) cycling, hampering maintenance of target Hb levels. We compared the frequency of dose changes in dialysis patients who received methoxy polyethylene glycolepoetin β (a continuous erythropoietin receptor activator (C.E.R.A.)) or a shorter-acting ESA. Methods: Data were analyzed from three Phase III maintenance trials, using almost identical protocols, in dialysis patients treated with C.E.R.A. every 2 weeks (q2w) or every 4 weeks (q4w) or a comparator ESA (epoetin or darbepoetin α at their previous dose/administration interval). Dosage was adjusted to maintain Hb ± 1 g/dl of baseline and 10-13.5 g/dl during titration (28 weeks) and evaluation (8 weeks), and 11-13 g/dl during follow-up (16 weeks). Results: Data were analyzed from 564 patients treated with C.E.R.A. q2w, 410 with C.E.R.A. q4w and 572 with comparator ESA at their usual dosing interval. Significantly fewer dose changes were needed in patients receiving C.E.R.A. q2w (p < 0.05) or C.E.R.A. q4w (p < 0.001) than in patients treated with comparator ESAs. Conclusion: This retrospective analysis suggests that C.E.R.A. q4w maintains Hb levels in dialysis patients and requires fewer dose changes compared with other ESAs.