I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Medicine Man on April 01, 2009, 10:45:52 AM
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This was a question posted on my introduction post. Just to make sure that it doesn't get out of hand with more questions, I thought I'd move the original question with my response here. I'm still trying to find out some more information and I'll post any new findings after this:
I have a question for you MM, concerning Epo. My understanding is that Epo (as opposed to Aranesp) is better absorbed by the body and therefore less is needed if it is given subcutaneously rather than into the lines during dialysis. .I live in Canada and used to dialyze at a self-care clinic so this was never an issue for me and I also used Aranesp, not Epo. However, I'm curious about your take on this. Thanks
First, let me start by saying that I am not a pharmacist. This is only my opinion.
Epogen, Aranesp, and Procrit all have the same active ingredient in them (it's called epotin alfa). They are different in the preservatives and maybe some other additives they use. Injecting epogen directly into you would be absorbed better only because you wouldn't be diluting it into the lines.
Some people also have a reaction to the different drugs (again, because of the preservatives). If you're used to taking the multi-dose version of epogen and then get switched to a single dose, you might feel a burning sensation. This is because the single dose doesn't contain the preservatives (which somehow numbs the body's reaction to epo).
I don't have much knowledge on Aranesp. but I would guess that if you could or would inject it subcutaneously it would work similar to epogen in a small amount.
I've also heard of studies about an additive that would make epo stay in the body longer and be absorbed better (thus less injections), but I can't remember off the top of my head what it was.
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I understand that Aranesp has a three times longer serum half life than Epo, which makes it better for injecting into lines while Epo is better done sub-cu.
I also thought that Aranesp is darbepoetin A while Epo is epoetin A. I think that it is generally felt that due to the longer half-life, Aranesp can be given less frequently (every one to two weeks for example) and is more cost-effective, although if someone reacts adversely then obviously Epo would be the obvious choice.
Let us know what you unearth in your research.
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From what I've gathered, you're right about the Aranesp lasting longer and thus needing fewer injections of it. I found an article that indicated a study done with both Aranesp and Epogen. Although the Epogen group had a slightly higher target achievement (80% for Epogen and 74% for Aranesp) it seems that both medicines work pretty identical to each other. I think it would boil down to either your body's reaction to the medicine or maybe even a little more control. IMO, if the Epogen is taken in shorter periods, then you could easily switch to a higher or lower dose faster depending on your hemoglobin levels.
In the years I've been shipping out Epogen, I notice that most of our patients get the same order month after month. Every once in a while they'll get a different dosage (usually due to a spike or drop in hemoglobin levels).
I don't know if this would make a difference, but the patients I ship to are only PD or Home Hemo. In center dialysis gets their Epogen from another place.
Also, if you're interested, here's the link to the test done: http://www.medicalnewstoday.com/articles/43769.php
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Also, if you're interested, here's the link to the test done: http://www.medicalnewstoday.com/articles/43769.php
Thanks for the link.
Just to note, the study was on cancer patients, not people on dialysis.
Not sure how much difference that makes.
8)