Treating CKD-Associated Anemia

One of the most common complications of chronic kidney disease (CKD) is renal anemia. The noninterventional, multicenter, pragmatic NAVIGO trial was designed to assess the effectiveness of methoxy polyethylene glycol-epoetin beta for the treatment of CKD-associated anemia in patients receiving dialysis in clinical practice in Poland. Methoxy polyethylene glycol-epoetin beta is a continuous erythropoietin receptor activator (CERA). Michal Nowicki, MD, and colleagues reported results of the trial.

A total of 247 patients receiving chronic intermitted dialysis in 26 centers in Poland were enrolled in the real-world study. Of those, 224 were receiving hemodialysis and 23 were receiving peritoneal dialysis. Eligible patients had CKD-associated symptomatic anemia, were not being treated with an erythropoietin stimulating agent, and had balanced iron stores. Over a period of 12 months, the researchers collected data on hemoglobin concentration and dosage, the route of administration and dosing scheme of CERA, dialysis adequacy, adverse events, iron therapy, and blood transfusion.

During treatment, a hemoglobin concentration of ≥10 g/dL was observed in 90.9% of study participants receiving hemodialysis and 96.0% of participants receiving peritoneal dialysis. At baseline, 7.8% of the overall cohort had a hemoglobin concentration of 10 to 12 g/dL. The percentage increased to 63.3% after 12 months.

The median time for maintenance of hemoglobin concentration within the 10 to 12 g/dL range was 115.2 days. After 7 months of treatment, a maximum 24.1% of patients in the hemodialysis group had a hemoglobin concentration ≥12 g/dL and maximum of 31.8% of the patients in the peritoneal dialysis group met that criterion. The median time between treatment initiation and the first hemoglobin concentration of >10 g/dL was 42.0 days. CERA was well tolerated.

In summary, the authors said, “CERA corrects CKD-associated anemia in dialysis patients, and maintains hemoglobin levels within the recommended target range. The study also confirmed the acceptable safety profile of the drug.”

Study identifier at ClinicalTrials.gov: NCT01690455

Source: Nephron