From the Guidelines
Darbepoetin is used to treat anemia in patients with chemotherapy-associated anemia and a hemoglobin concentration approaching or below 10 g/dL, as well as in patients with declining hemoglobin levels but less severe anemia, to increase hemoglobin and decrease transfusions. According to the 2007 American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update 1, darbepoetin is considered equivalent to epoetin in terms of effectiveness and safety for patients with chemotherapy-induced anemia. The guideline recommends using darbepoetin or epoetin as a treatment option for patients with chemotherapy-associated anemia and a hemoglobin concentration that is approaching, or has fallen below, 10 g/dL.
Key considerations for using darbepoetin include:
- Conducting a thorough history and physical examination to identify correctable causes of anemia before initiating therapy
- Considering relevant diagnostic testing, such as iron, folate, and B12 deficiency, and assessing for occult blood loss and renal insufficiency
- Minimizing use of erythropoiesis-stimulating agents (ESAs) in patients with high risk of thromboembolic events
- Carefully weighing the risks of thromboembolism in patients for whom darbepoetin is prescribed, as randomized clinical trials and systematic reviews demonstrate an increased risk of thromboembolism in patients receiving ESAs 1.
The FDA-approved starting dose of darbepoetin is 2.25 μg/kg weekly or 500 μg every 3 weeks subcutaneously 1. Dose escalation should follow FDA-approved labeling, with no convincing evidence to suggest differences in dose escalation schedules are associated with different effectiveness. Patients should be monitored regularly for potential side effects, and the decision to use darbepoetin should be determined by clinical circumstances, including the severity of anemia, underlying medical conditions, and the risk of thromboembolic events.
From the FDA Drug Label
11 DESCRIPTION Darbepoetin alfa is an erythropoiesis-stimulating protein
The FDA drug label does not answer the question.
From the Research
Darbepoetin Usage
- Darbepoetin-alpha is a hyperglycosylated erythropoiesis-stimulating protein used to stimulate bone marrow to produce red blood cells 2.
- It is used to treat anemia in patients with chronic kidney disease (CKD) and has a longer terminal half-life than recombinant human erythropoietin (rHuEPO), allowing for less frequent dosing 2.
- Darbepoetin-alpha maintains hemoglobin values within target range and has a similar adverse effect profile to rHuEPO 2.
Anemia Treatment
- Erythropoiesis stimulating agents, including darbepoetin, are used to manage anemia in patients with CKD, cancer, and other conditions 3.
- These agents have different clinical characteristics and stabilities due to chemical modifications, and their effectiveness varies depending on individual patient characteristics and etiologies of anemia 3.
- Treatment with erythropoiesis stimulating agents, including darbepoetin, is dependent on hemoglobin levels and requires monitoring by a physician 3.
Health-Related Quality of Life
- Epoetin alfa, another erythropoiesis stimulating agent, has been shown to improve health-related quality of life (HRQL) in patients with anemia associated with cancer, HIV/AIDS, and CKD 4.
- Improvements in HRQL, particularly with regard to fatigue, have been observed in patients receiving epoetin alfa 4.
- While darbepoetin is not specifically mentioned in this study, its use as an erythropoiesis stimulating agent suggests it may have similar effects on HRQL 2, 4.