Mircera in the treatment of dialysis patients: pilot study

Abstract

Mircera is a pegylated β-epoietin that offers the possibility of biweekly or monthly administration unlike other similar drugs. For 12 weeks in the Chisinau Dialysis Center No. 1 in 2018 there was conducted a prospective single-center study regarding the replacement of Recormon (classic β-epoietin) with Mircera (pegylated β-epoietin) in order to determine the conversion dose. In 3 groups of 10 patients on chronic dialysis and on stable dose of Recormon (IU) we replaced the respective drug with Mircera (mcg): 4000 IU/week = 50 mcg/week, 6000 IU/week = 50 mcg/3 weeks and 8000 IU/ week = 50 mcg/2 weeks. There was determined the patients’ haemoglobin level, haematocrit and erythrocyte count at baseline and every 4 weeks. During the study 5 patients were excluded due to new onset haemorrhagic syndrome. As a result we observed reduction of hemoglobin from 107.8±4.2 g/l to 102.3±3.9 g/l (p<0.05) and hematocrit from 32.1±1.7% to 30.2±1.9% (M±m). The effect was larger in patients with hepatitis (-5.8±4.7 g/l vs -4.0±3.9 g/l). There was also noted the direct influence of greater values of erythropoietin resistance index on treatment failure (p≈0.03). Mircera treatment is well tolerated by patients, and the recommended replacement dose of Mircera equates to 4 mcg Mircera ≈ 1000 IU Recormon in patients with the sustaining dose 4000-8000 IU/week.