Utilization of darbepoetin alfa and epoetin alfa for chemotherapy-induced anemia

Purpose. The patterns of use and effectiveness of therapy with darbepoetin alpha and epoetin alfa for chemotherapy-induced anemia (CIA) in hospital outpatient and community settings were evaluated. Methods. Data were collected from medical charts at 65 oncology clinics in hospital outpatient and comunity settings for consecutive patients who received the first dose of either darbepoetin alfa or epoetin alfa between August 1, 2002, and February 15, 2003, and were to have 12 weeks of follow-up data. Results. Data from the charts of 3123 patients were abstracted. Of these patients, 2785 were treated with only one erythropoietic agent (1444 with darbepoetin alfa and 1341 with epoetin alfa) and were included in the analysis. The most common initial dosage of darbepoetin alfa was 200 μg every two weeks (61% of darbepoetin alfa recipients), and the most common initial dasage of epoetin alfa was 40, 000 units weekly (72%). With these regimens, the dosage was escalated for 22% of epoetin alfa recipients at a median of six weeks after the initial dose. The mean change from baseline in hemoglobin concentration after 12 weeks of therapy was similar for both groups, as was the percent of patients with red-blood-cell transfusions during treatment. Conclusion. The most common initial dosage of darbepoetin alfa for CIA was 200 μg every two weeks, and the most common initial dosage of epoetin alfa was 40,000 units weekly. At these dosages, the two agents appear to have similar clinical effectiveness. Index terms : Anemia, Antineaplastic agents ; Darbepoetin alfa ; Dosage ; Drug comparisons ; Drug use ; Epoetin alfa ; Hematopoietic agents ; Toxicity. Am J Health-Syst Pharm. 2005 ; 62:54-62