甲氧基聚乙二醇-促生成素治疗慢性肾病相关性贫血

T. Patel, Ajay K. Singh
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引用次数: 1

摘要

由红细胞生成素相对缺乏引起的贫血通常是慢性肾脏疾病(CKD)的并发症。随着20年前重组红细胞生成素的引入,CKD患者的输血需求显著减少。促红细胞生成素是第一代促红细胞生成素,由于其半衰期短,需要经常使用。甲氧基乙二醇-促红细胞生成素β是一种长效ESA,作为一种连续的促红细胞生成素受体激活剂,每2至4周给予一次。在短期临床研究中,已观察到甲氧基聚乙二醇-生成素β在维持血红蛋白水平在目标范围内的安全性和有效性方面与其他esa相当。然而,血红蛋白不再是临床有效的安全性替代品,即贫血的纠正并不能转化为更好的临床结果。缺乏评估硬终点(如死亡和心血管事件)的长期研究。自2007年以来,甲氧基聚乙二醇-乙生成素已被批准在欧盟使用,而在美国则因法律原因被禁止使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of Anemia Associated with chronic Kidney Disease with Methoxy polyethylene Glycol- epoetin Beta
Anemia resulting from a relative deficiency of erythropoietin commonly complicates chronic kidney disease (CKD). With the introduction of recombinant erythropoietin two decades ago, there has been a dramatic reduction in the need for blood transfusions in CKD patients. Epoetin alpha is a first generation erythropoiesis stimulating agent (ESA) that needs to be administered frequently because of its short half-life. Methoxy ethylene glycol-epoetin beta is a longer acting ESA that acts as a continuous erythropoietin receptor activator and is given once every 2 to 4 weeks. In short term clinical studies, Methoxy polyethylene glycol-epoetin beta has been observed to be comparable with other ESAs with regard to safety and efficacy in maintaining hemoglobin levels in the target range. However, hemoglobin is no longer a clinically valid surrogate for safety i.e. correction of anemia does not translate into better clinical outcome. Long term studies evaluating hard end-points such as death and cardiovascular events are lacking. Methoxy polyethylene glycol-epoetin beta has been approved for use in the European Union since 2007 while its use in the United States is prohibited on legal grounds.
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