Summary

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• Darbepoetin alfa (Aranesp) is recommended for the management of anemia due to Chronic Kidney Disease (CKD) in both dialysis and non-dialysis patients, as well as for anemia resulting from myelosuppressive chemotherapy. It is effective in preventing blood transfusions in adults with CKD, demonstrating similar efficacy to other erythropoiesis-stimulating agents such as epoetin alfa and beta.
• The information was derived from three systematic reviews/meta-analyses that compared Aranesp's safety and efficacy against placebo, other ESAs like epoetin alfa/beta, and novel treatments including vadadustat.
• In terms of mortality risk associated with its use, darbepoetin alfa shows no significant difference when compared to a placebo or other evaluated ESAs, indicating comparable safety concerns related to mortality.
• However, darbepoetin may increase the odds of hypertension more than a placebo does. This potential side effect is common among different erythropoiesis-stimulating agents used for treating anemia due to CKD.
• When comparing newer treatments like vadadustat or Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), there is no significant difference between them and darbepoetin alfa regarding hemoglobin level elevation or all-cause mortality rates; however, vadadustat might be slightly less effective at raising hemoglobin levels, specifically within dialysis-dependent chronic kidney disease patients.
• The studies considered various patient populations segmented into nondialysis-dependent (NDD) and dialysis-dependent (DD). Across these subgroups, Aranesp maintains a consistent efficacy profile while also indicating a possible increased risk of hypertension, which warrants specific considerations during treatment management.