Safety and usage of darbepoetin alfa in children with chronic kidney disease: prospective registry study

Pediatr Nephrol. 2016 Mar;31(3):443-53. doi: 10.1007/s00467-015-3225-0. Epub 2015 Oct 19.

Abstract

Background: Limited prospective data are available on the long-term safety of darbepoetin alfa (DA) for treating anemia in children with chronic kidney disease (CKD).

Methods: In this prospective, phase IV, observational registry study, children ≤16 years of age with CKD anemia and receiving DA were observed for ≤2 years. Adverse events (AEs), DA dosing, hemoglobin (Hb) concentrations, and transfusions were recorded.

Results: A total of 319 patients were included in the analysis (mean age, 9.1 years), 158 (49.5%) of whom were on dialysis at study entry. Of 434 serious AEs reported in 162 children, the most common were peritonitis (10.0%), gastroenteritis (6.0%), and hypertension (4.1%). Six patients (1.9%) died (unrelated to DA). Four patients (1.3%) experienced six serious adverse drug reactions. The geometric mean DA dose range was 1.4-2.0 μg/kg/month. Mean baseline Hb concentration was 11.1 g/dl; mean values for children receiving and not receiving dialysis at baseline ranged between 10.9 and 11.5 g/dl and 11.2-11.7 g/dl, respectively. Overall, 48 patients (15.0%) received ≥1 transfusion.

Conclusions: No new safety signals for DA were identified in children receiving DA for CKD anemia for ≤2 years. Based on Hb concentrations and transfusion requirements, DA was effective at managing anemia in these patients.

Keywords: Adverse events; Anemia; Chronic kidney disease; Darbepoetin alfa; Hemoglobin; Pediatric.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Anemia / blood
  • Anemia / diagnosis
  • Anemia / drug therapy*
  • Anemia / etiology
  • Biomarkers / blood
  • Blood Transfusion
  • Child
  • Child, Preschool
  • Darbepoetin alfa / adverse effects
  • Darbepoetin alfa / therapeutic use*
  • Europe
  • Female
  • Hematinics / adverse effects
  • Hematinics / therapeutic use*
  • Hemoglobins / metabolism
  • Humans
  • Infant
  • Male
  • Prospective Studies
  • Registries
  • Renal Dialysis* / adverse effects
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / therapy*
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Hematinics
  • Hemoglobins
  • Darbepoetin alfa