Effects of the once- versus twice-monthly administration of epoetin beta pegol on ferrokinetics, including hepcidin-25 levels, in patients undergoing hemodialysis

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  • 血液透析患者に対するEpoetin beta pegol月1回投与と月2回投与でのヘプシジン25を指標とした鉄動態の検討
  • ケツエキ トウセキ カンジャ ニ タイスル Epoetin beta pegolゲツ 1カイ トウヨ ト ツキ 2カイ トウヨ デ ノ ヘプシジン 25 オ シヒョウ ト シタ テツ ドウタイ ノ ケントウ

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【Background】We examined the effects of once- or twice-monthly continuous erythropoietin receptor activator (CERA) administration on ferrokinetics, particularly the hepcidin-25 level and erythropoiesis-stimulating agent resistance index (ERI), in anemic patients undergoing hemodialysis.【Methods】A 1-year prospective study of 24 patients undergoing hemodialysis was performed. Group A (n=12) was administered CERA once a month, and Group B (n=12) was administered CERA twice a month. We compared the subjects' hepcidin-25, serum iron, transferrin saturation, ferritin, hemoglobin, and target maintenance hemoglobin levels, as well as their ERI values and the change in the CERA dose between the two groups.【Results】There were no differences in sex, age, hemodialysis duration, the baseline hemoglobin level, the ferritin level, or the CERA dose between the two groups. Both groups displayed significantly decreased hepcidin-25 levels at 1 week. Group B exhibited significantly lower hepcidin-25 levels than Group A at 1 month, 3 months, and 1 year. Similar tendencies were seen for the subjects' serum iron, transferrin saturation, and ferritin levels. The CERA dose decreased significantly in Group B, but not in Group A. The ERI increased by 0.4% in Group A, but decreased by 10.5% in Group B. However, no inter- or intra-group differences were noted.【Conclusion】Changes in the CERA dose had significant ferrokinetic effects, including on the hepcidin-25 level. Twice-monthly CERA administration might prevent neocytolysis and promote bone marrow hematopoiesis.

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