A prospective randomized pilot trial comparing weekly vs. biweekly Darbepoetin administration to preterm infants.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-03-06 DOI:10.1038/s41372-025-02247-8

Timothy M Bahr, Robert D Christensen, Kimberlee A Weaver-Lewis, Danielle M Scott, Erick Gerday, Jared J Tuttle, Robin K Ohls

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Abstract

Background: Administering darbepoetin (Darbe) to preterm infants stimulates erythropoiesis, increases red blood cell (RBC) mass, and reduces RBC transfusions. We typically administer 10 µg/kg weekly until 34 weeks corrected gestation; however, we are uncertain whether this dose could be given every other week (biweekly) with equal efficacy.

Methods: Infants ≤32 weeks were randomized to receive Darbe 10 µg/kg/dose weekly or biweekly for six weeks, tracking complete blood counts, absolute reticulocyte counts (ARC), iron status (RET-He), and RBC transfusions.

Results: We enrolled 71 infants (1027 ± 369 grams, 27.3 ± 2.8 weeks). During the study period, the weekly-dosed group had a higher adjusted mean ARC (48,000/μL higher, 95% C.I. 9700-87,000/μL; p = 0.019). However, RET-He, Hgb, and transfusion-free survival were not different between groups (p = 0.071, p = 0.244, and p = 0.762).

Conclusions: Weekly Darbe results in a higher six-week ARC than biweekly dosing. However, given similar clinical outcomes, perhaps biweekly dosing may be a cost-effective alternative.

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一项前瞻性随机试验，比较了早产儿每周服用达贝泊汀与每两周服用达贝泊汀的情况。

背景：给予早产儿达贝泊丁（Darbe）刺激红细胞生成，增加红细胞（RBC）质量，减少红细胞输注。我们通常每周给药10微克/千克，直到纠正妊娠34周；然而，我们不确定该剂量是否可以每隔一周（两周一次）给予相同的疗效。方法：≤32周的婴儿随机接受Darbe 10µg/kg/剂量，每周或每两周，持续6周，跟踪全血细胞计数、绝对网织红细胞计数（ARC）、铁状态（RET-He）和红细胞输注。结果：纳入71例婴儿（1027±369克，27.3±2.8周）。在研究期间，每周给药组的校正平均ARC较高(48000 /μL， 95% ci为9700 ~ 87000 /μL；p = 0.019)。RET-He、Hgb、无输血生存期组间差异无统计学意义（p = 0.071、p = 0.244、p = 0.762）。结论：每周Darbe的6周ARC高于每两周给药。然而，考虑到类似的临床结果，也许每两周给药可能是一种具有成本效益的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.