Drug May Boost Hemoglobin in Chronic Kidney Disease

Erythropoietin-receptor agonist can wean anemic patients from supportive blood transfusions

WEDNESDAY, Nov. 4 (HealthDay News) -- Patients with chronic kidney disease and a deficit in red blood cells resulting from anti-erythropoietin antibodies were able to stop supportive blood transfusions following injections of an erythropoietin-receptor agonist in a British study reported in the Nov. 5 New England Journal of Medicine.

Iain C. Macdougall, M.D., of King's College Hospital in London, and colleagues recruited 14 chronic kidney disease patients with pure red-cell aplasia or hypoplasia caused by anti-erythropoietin antibodies and injected them with a synthetic peptide-based erythropoietin-receptor agonist every four weeks. The study end point was hemoglobin concentration higher than 11 g per deciliter.

With a median 28 months treatment, the researchers found that the median hemoglobin concentration rose from baseline 9.0 g per deciliter (including 12 patients whose baseline hemoglobin was supported by blood transfusions) to 11.4 g per deciliter. Within 12 weeks of the initial dose, 13 patients no longer required supportive transfusions. Anti-erythropoietin antibody levels declined during the study period until they could no longer be detected in six patients. One initially responsive patient, who was found to have antibodies against the agonist, lost response after a few months and supportive transfusions were resumed. While most adverse events were mild, one patient died from a vascular adverse event within months of the last dose, and seven patients suffered grade 3 and 4 adverse events.

"This study shows that a synthetic peptide-based erythropoietin-receptor agonist can stimulate erythropoiesis in patients with pure red-cell aplasia caused by the presence of anti-erythropoietin antibodies," the authors write.

Several study authors reported receiving consulting fees, lecture fees and research support from, or owning equity in, several pharmaceutical companies.

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