Darbepoetin alfa: A new erythropoietic drug for the treatment of renal anaemia

Darbepoetin alfa (Aranesp®), Amgen Ltd) is a long-acting, hyperglycosylated recombinant human erythropoietin (r-HuEPO; epoetin) analogue, developed for the treatment of anaemia in patients with chronic kidney disease (CKD, i.e. end-stage renal failure or progressive renal impairment). Based on previously published European guidelines, this review article presents key recommendations for the use of darbepoetin alfa in Australasian clinical practice. Darbepoetin alfa is expected to be a valuable alternative therapeutic agent for the management of renal anaemia. Clinical data demonstrate that: Once-weekly administration of darbepoetin alfa - whether by subcutaneous (s.c.) or intravenous (i.v.) injection - is as effective as epoetin therapy, administered two or three times per week; patients receiving once-weekly doses of epoetin can be switched to darbepoetin alfa, once every 2 weeks; target haemoglobin (Hb) concentrations can be successfully maintained in patients switched from epoetin therapy to less frequently administered doses of darbepoetin alfa (administration once every 2 weeks is sufficient for some patients); and darbepoetin alfa has a similar safety profile to epoetin. In addition to addressing a number of practical considerations relating to the use of darbepoetin alfa in clinical practice, this article also highlights principal findings from several key clinical studies.