Continuous Erythropoietin Receptor Activator for the Treatment of Chronic Dialysis Patients with Renal Anemia in Daily Clinical Practice in Poland: A Non-Interventional, Multi-Center, Pragmatic NAVIGO Trial

Nephron. 2024;148(2):104-112. doi: 10.1159/000534070. Epub 2023 Sep 14.

Abstract

Background: Renal anemia is one of the most common complications of chronic kidney disease (CKD). This real-life study assessed the effectiveness of methoxy polyethylene glycol-epoetin beta, a continuous erythropoietin receptor activator (C.E.R.A.), for the treatment of CKD-associated anemia in patients receiving dialysis in daily clinical practice.

Methods: 247 patients receiving chronic intermitted dialysis in 26 centers in Poland with CKD-associated symptomatic anemia, ESA-naïve, and with balanced iron stores in the investigators' opinion were enrolled this real-life study. Over 12 months, the following data were collected: hemoglobin (Hb) concentration and dosage, route of administration and dosing scheme of C.E.R.A., dialysis adequacy, adverse events, iron therapy, and blood transfusions.

Results: During the treatment, a Hb concentration of ≥10 g/dL was noted in 90.9% of hemodialysis patients (n = 224) and 96.0% of peritoneal dialysis patients (n = 23). At baseline, 7.8% of patients had a Hb concentration of 10-12 g/dL, which increased to 63.3% after 12 months. The median time when Hb concentration was maintained within 10-12 g/dL was 115.2 (interquartile range 49.1-188.7) days. A Hb concentration ≥12 g/dL was observed after 7 months of treatment in a maximum of 24.1% of hemodialysis patients, and 31.8% of peritoneal dialysis patients. The median time elapsed between the start of treatment and the first Hb concentration >10 g/dL was 42.0 (21.0-78.2) days. C.E.R.A. was well tolerated.

Conclusions: C.E.R.A. corrects CKD-associated anemia in dialysis patients, and maintains Hb levels within the recommended target range. The study also confirmed the acceptable safety profile of the drug.

Keywords: Chronic kidney disease; Dialysis; Methoxy polyethylene glycol-epoetin beta; Renal anemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia* / drug therapy
  • Anemia* / etiology
  • Chronic Disease
  • Erythropoietin* / therapeutic use
  • Hematinics* / therapeutic use
  • Hemoglobins / analysis
  • Humans
  • Iron
  • Poland
  • Polyethylene Glycols*
  • Renal Dialysis / adverse effects
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy

Substances

  • continuous erythropoietin receptor activator
  • Hemoglobins
  • Erythropoietin
  • Iron
  • Hematinics
  • Polyethylene Glycols

Grants and funding

The study was funded by Roche Poland and Polish Society for Research in Kidney Diseases (PTBChN). Services provided by Proper Medical Writing Sp. z o.o. were sponsored by Roche Poland.