209810-58-2

Treatment of anemia.

Treatment of anaemia associated with chronic renal failure, and with non-haematological malignancies in adult cancer patients receiving chemotherapy

Darbepoetin may potentially be useful in treating anemia of chronic kidney disease in dogs and cats. It may be less immunogenic than epoetin, but this is only theoretical and has not been documented. Another advantage is that doses may be administered less often to maintain PCV. Treatment costs may be higher than using epoetin, however.

The metabolic fate of both endogenous and recombinant erythropoietin is poorly understood. Current evidence from studies in animals suggests that hepatic metabolism contributes only minimally to elimination of the intact hormone, but desialylated epoetin (ie, terminal sialic acid groups removed) appears to undergo substantial hepatic clearance via metabolic pathways and/or binding. Desialylation and/or removal of the oligosaccharide side chains of erythropoietin appear to occur principally in the liver; bone marrow also may have a role in catabolism of the hormone.
Elimination of desialylated drug by the kidneys, bone marrow, and spleen also may occur; results of animal studies suggest that proximal renal tubular secretion may be involved in renal elimination. In preclinical studies it has been shown that renal clearance of darbepoetin is minimal (up to 2% of total clearance).