Evaluation of the safety and immunogenicity of subcutaneous HX575 epoetin alfa in the treatment of anemia associated with chronic kidney disease in predialysis and dialysis patients

Clin Nephrol. 2017 Oct;88(10):190-197. doi: 10.5414/CN109159.

Abstract

Aim: To assess the safety and immunogenicity of subcutaneous (SC) HX575 (epoetin-α) in dialysis- and nondialysis-dependent adult patients with chronic kidney disease (CKD).

Methods: Open-label, single-arm, multicenter study in patients (n = 416) from Germany, Italy, Poland, Romania, Russia, Turkey, and Ukraine.

Results: Mean (standard deviation (SD)) age was 52.3 (15.8) years, all patients were Caucasian, and similar proportions were male/female. 250 patients (60.1%) were erythropoiesis-stimulating agent (ESA)-naïve, and 166 (39.9%) were receiving ESA maintenance therapy at study start; mean (SD) on-study treatment duration with HX575 was 43.4 (15.8) weeks and 45.3 (13.7) weeks, respectively. Binding antierythropoietin (EPO) antibodies were detected by radioimmunoprecipitation (RIP) assay in 7 patients (1.7%; incidence 0.019); 5 of these were ESA-naïve at study entry. No patient developed neutralizing antibodies as determined in a cell-based epoetin neutralizing assay. Of the 7 patients with a positive binding anti-EPO RIP assay, 4 tested negative at later time points while continuing HX575 treatment. Three patients had low titers of anti-EPO antibodies at the last study assessment. There were no clinical signs of immunogenicity or hypersensitivity.

Conclusions: SC HX575 was effective for correcting and maintaining correction of anemia, and the mean weekly dose remained stable over time. .

MeSH terms

  • Adult
  • Aged
  • Anemia / drug therapy*
  • Anemia / etiology
  • Epoetin Alfa / adverse effects*
  • Epoetin Alfa / therapeutic use
  • Erythropoietin
  • Europe
  • Female
  • Hematinics / adverse effects*
  • Hematinics / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Recombinant Proteins / adverse effects*
  • Recombinant Proteins / therapeutic use
  • Renal Dialysis / adverse effects*
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / therapy

Substances

  • EPO protein, human
  • Hematinics
  • Recombinant Proteins
  • Erythropoietin
  • Epoetin Alfa