2016, Number 6
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Revista Habanera de Ciencias Médicas 2016; 15 (6)
Effectiveness and safety in the use of ior® EPOCIM in predialysis patients. Clinical trial
Vargas BA, Pérez-Oliva DJ, Robaina GM, Piedra SP, Mendoza Hv, Román RY
Language: Spanish
References: 21
Page: 1029-1041
PDF size: 313.32 Kb.
ABSTRACT
Introduction: The ior
® EPOCIM (human recombinant erythropoietin) is a Cuban medicament produce by the Molecular Immunology Center, which result safety, not being adverse results associated to its use in dialytic patients, but regarding predialysis patients the disclosed information is not enough.
Objective: To evaluate effectiveness and safety of ior
® EPOCIM in patients with Chronic Kidney Disease (CKD) in pre-dialysis, stages 3 and 4.
Material and Methods: Was performed a multicenter, opened, non-randomized phase IV clinical trial, which included 242 patients with and without anemia. During a 12 months period was evaluated the treatment with ior
® EPOCIM, with an initial dose of 30 U/kg/dose; and them increase according to the hematologic response up to a dose of 150 U/Kg/ to achieve the hemoglobin’s stabilization between 10.5-12.5 g/dL and/or hematocrit between 33-36%.
Results: The initial mean value for hemoglobin was 10 (SD ± 1.5 g / dl) it gradually increased until the 4th month stabilizing its value in 11.7 (SD ± 1.2 g / dl); hematocrit had similar behavior. Renal function remained stable. The life quality improved, was a greater benefit in the scale of the physical role and general health. 147 adverse events were reported; they had some causal relationship 13.6%. The most frequent event was hypertension (44.9%). No death was related with the product.
Conclusions: ior
® EPOCIM was safe and effective in this population.
REFERENCES
National Kidney Foundation. KDOQI. Clinical Practice Guideline for Diabetes and Chronic Kidney Disease: 2012 Update. American Journal of Kidney Diseases. 2012; 60( 5): 850 - 886.
Babitt JL, Lin HY. Mechanisms of Anemia in CKD. Journal of the American Society of Nephrology : JASN. 2012; 23(10):1631-1634.
Parker PA, Izard MW, Maher JF. Therapy of iron deficiency anemia in patients on maintenance dialysis. Nephron. 1979;23:181-6.
Potasman I, Better OS. The role of secondary hyperparathyroidism in the anemia of chronic renal failure. Nephron. 1983;33:229-31.
Adamson JW, Eschbach JW. Management of the anaemia of chronic renal failure with recombinant erythropoietin. Q J Med 1989;New Series. 73:1093-101.
Eschbach JW, Funk DD, Adamson J, Kuhn K, Scribner BH, Finch CA. Erythropoiesis in patients with renal failure undergoing chronic dialysis. N Engl J Med 1967;276:653-58.
Eschbach JW. The future of r-HuEPO. Nephrol Dial Transplant. 1995;10Suppl 2:96-109.
Kaiser I, Schwartz KA. Aluminium induced anemia. Am J Kidney. 1985;6:348-52.
Escalante ER. Anemias del recién nacido. Guía para el uso de eritropoyetina. Rev Hosp Mat Inf Ramón Sardá. 2001;20(3).
Chávez LA, Flores NG. Uso de Eritropoyetina Recombinante Humana (r-HuEPO) para evitar anemia en pacientes pretérmino . Rev Hosp M Gea Glez. 2000;3(4):157-62.
Barrio A, Guemes M. Evolución del consumo de eritropoyetina en un hospital general durante el período 1991-1999. (Accessed January 12, 2015). Disponible en: http://abgf@bio.hgy.es
Centro para el control estatal de medicamentos, equipos y dispositivos médicos CECMED. (Internet). Cuba: Ministerio de Salud Pública de Cuba. 2014 [citado 15 marzo de 2016]. Resumen de las características del ior® EPOCIM; [aprox. 9 páginas].
Valderrábano F. Tratado de Hemodiálisis.1999:317-88.
KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Use of ESAs and other agents to treat anemia in CKD. Kidney International Supplements. 2012; 2: 299-310.
Cabrera García L, Ruiz Antorán B, Sancho López A. Eritropoyetina: revisión de sus indicaciones. IT del Sistema Nacional de Salud. 2009;(3): 1.
Singh A K, Szczech L, Kezhen L. Tang, Barnhart H, Sapp S, Wolfson M, Reddan D, for the CHOIR Investigators. Correction of Anemia with Epoetin Alfa in Chronic Kidney Disease. N Engl J Med. 2006; 355:2085-98.
Drüeke TB, Locatelli F, Clyne N y cols. Normalization of Hemoglobin Level in patients with Chronic Kidney Disease and Anemia (CREATE). N Engl J Med. Nov 2006;2071-84.
Cody JD, Daly C, Campbell MK, Khan I, Rabindranath KS, Vale L, Wallace SA, MacLeod AM, Grant AM, Pennington S, Nistor I, Bolignano D, Webster AC. Rev. Cochrane. Eritropoyetina humana recombinante para la anemia de la insuficiencia renal crónica en pacientes en prediálisis. Cochrane Database of Systematic Reviews 2014; Issue 2.
Akisawa T, Saito A, Gejyo F, et al. Impacts of Recombinant Human Erythropoietin Treatment During Predialysis Periods on the Progression of Chronic Kidney Disease in a Large-Scale Cohort Study (Co-JET study). Therapeutics Apheresis and Dialysis. 2014;18(2): 140-8.
Palmer SC. Navaneethan SD. Craig JC. Johnson DW. Tonelli M. Garg AX. Pellegrini F. Ravani P. Jardine M. Perkovic V. Graziano G. McGee R. Nicolucci A. Tognoni G. Strippoli GF. Meta-analysis: erythropoiesis-stimulating agents in patients with chronic kidney disease. Ann Intern Med. 2010;153(1):23-33.
Singh A K. Does TREAT give the boot to ESAs in the treatment of CKD anemia? J. Am. Soc. Nephrol. 2010; 21: 2-6.