Renal anaemia - CKD 1-5
Rattachement africain : it, es, fr, us, pl, gb, ro, de. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Introduction and Aims: Hemoglobin (Hb) stability with C.E.R.A. once-monthly (QM) was evaluated in high risk patients with chronic kidney disease (CKD) on dialysis switched from shorter-acting erythropoiesis-stimulating agents (ESAs).Methods: Adult CKD patients on dialysis were converted to C.E.R.A. QM to achieve a target Hb of 10.0-12.0g/dL (5 studies), 10.5-12.5 g/dL (3 studies), 11.0-12.5 g/dL and 11-13 g/dL (one study each).High risk (HR) and low risk (LR) subgroups were defined on the basis of therapy parameters before switching: epoetin or darbepoetin alfa dose (=8000 IU or 40 μg, respectively), average Hb at screening (below the 40% percentile [ P60] for LR).The ratio of dose and achieved Hb at screening >P60 (HR), or Hb fluctuation >P60 (HR) were defined by the same parameters.Cardiovascular (CV) risk groups were defined by pre-existing cardiac risk factors (diabetes or cardiac disorder), or through >P60 N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels.Treatment switchover was followed by a 16-week titration and an 8-week evaluation period.Hb parameters, dosing and safety in the evaluation period were compared.Results: Patients (N=1577); median age 63 (range: 19-93) years were classified into HR/LR subgroups as shown in the table.Evaluation of therapy-related subgroups showed generally significantly higher mean Hb values for the LR subgroups.The largest difference (0.4 g/dL) was seen for subgroups by dose/Hb, while subgroups by Hb fluctuation showed no difference.The difference seen for the HR/LR screening Hb group represented a reduction from 1.2 g/dL difference at screening to 0.3 g/dL after the switch to C.E.R.A.There was less variation in mean Hb levels for the HR/LR subgroups by CV risk factors.Hb stability (mean Hb within target range or change from baseline =1 g/dL) was similar across all subgroups.Mean required C.E.R.A. dose QM was higher for all HR groups than the LR counterparts, with significant differences for four of the comparisons.As expected, significantly higher frequencies of cardiac and vascular SAEs were seen in HR versus LR patients for NT-proBNP (HR/LR, 5.7/1.9;p<0.004 for cardiac SAEs) and baseline risk factors (4.6/2.0;p<0.02 for cardiac SAEs; 4.9/1.3;p=0.0004 for vascular SAEs).Conclusions: The pooled analysis in dialysis patients shows that C.E.R.A. QM maintains stable Hb levels in all HR patients as well as in patients with prevailing CV risk factors.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Renal anaemia - CKD 1-5
- Date Crossref
- 01/05/2012
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Messina pays non établi dans la noticeUniversité ou école supérieure
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Althaia pays non établi dans la noticeOrganisation à but non lucratif
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Hopitaux Civils de Colmar pays non établi dans la noticeÉtablissement de santé
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Marqués de Valdecilla University Hospital pays non établi dans la noticeÉtablissement de santé
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Affymax (United States) pays non établi dans la noticeEntreprise
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Medical University of Silesia Department of Nephrology pays non établi dans la noticeUniversité ou école supérieure
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Royal Derby Hospital pays non établi dans la noticeÉtablissement de santé
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Bellvitge University Hospital pays non établi dans la noticeÉtablissement de santé
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Hospital Universitari Germans Trias i Pujol pays non établi dans la noticeÉtablissement de santé
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Fundación Hospital Manacor pays non établi dans la noticeÉtablissement de santé
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Alessandro Manzoni Hospital pays non établi dans la noticeÉtablissement de santé
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Vall d'Hebron Hospital Universitari pays non établi dans la noticeÉtablissement de santé
University of Messina, Althaia et Hopitaux Civils de Colmar, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.