Comparative study between darbepoetin vs. metoxi polietilen glycol-epoetin beta (CERA), in the treatment of anemia in patients with chronic hemodialysis: Randomized clinical trial

Background: At present, we have differents erithropoyesis stimulating agents (ESA) for the treatment of anemia in chronic hemodialysis. In the last ten years, news ESA have been improved as Darbepoyetin (DA) and methoxy polyethylene glycol epoetin beta (CERA), theses ESA have better pharmacologyc efficacy and less frequency of administration. We did a randomized clinical trial between DA and CERA in the treatment of anemia in hemodialysis. Methods: 160 adults patients in chronic hemodialysis with anemia (Hb 8 g/dl, Hto 24%)) were included, patients with malnutrition, cancer, multiorganic failure and older than 75 years were excluded. Patients were randomized in two groups, DA (n=80) received 40 mg every 5 days, subcutaneous route and CERA group (n=80)) received 75 mcg, every 10 days, subcutaneous route. The medications were taken in a double blind way. Hb and Hto were taken at the beginning of the study and monthly during 4 months. Ferrum profile was taken at the beginning and at the end of the study. ANOVA was used for the comparison of values the Hb and Hto in the differents measures. P values less 0.05 were considered significant. Results: The basal values of Hb and hto in the DA group were: 9±1 g/dl and 27±2%, in the M group were: 8.9±1 g/dl and hto 28±1% (p > 0.05), at the end of study in the DA group Hb 12±1 g/dl and hto 36±2% in the M group Hb 11.9±1 g/dl and hto 35±1 % (p > 0.05). Ferritin and transferrin saturation were similar in both groups at the beginning and at the end of the study (p >0.05). Conclusions: Darbopoyetin and Mircera had the same efficacy in the treatment of anemia in chronic hemodialysis, there were not differences. Both options are useful for the treatment in patients in hemodialysis.