Clinical Comparison of Renogen, a Biosimilar Epoetin-a, with the Originator, Eprex, in Chronic Kidney Disease Anemia in Indonesia: A Preliminary Study
Keywords:
renal anemia, erythropoietin, biosimilar, hemodialysisAbstract
Background: treatment of erythropoietin (EPO) is essential in chronic kidney disease (CKD) patients to maintain optimal hemoglobin (Hb) level. Renogen is a biosimilar epoetin-α, and Eprex is the originator epoetin-α. This study aimed to compare the efficacy and tolerance of Renogen with Eprex in CKD anemia. Methods: Renogen and Eprex were compared in a randomized (2:1), open-label study for 8 weeks, proceeded by 4 weeks adjustment (maintenance) phase, in anemic CKD patients undergoing HD in Cipto Mangunkusumo General Hospital, Jakarta, from June 2017 to October 2018. Results: a total of 45 patients (31 received biosimilar EPO and 14 received originator EPO) were included in the study. At baseline, mean (SD) Hb levels were 10.9 (0.74) g/dL and 10.9 (0.61) g/dL in biosimilar and originator EPO groups, respectively. At end of study (8 weeks), mean (SD) Hb levels were 10.5 (1.28) g/dL and 11.0 (1.13) g/dL in biosimilar EPO and originator EPO groups, respectively. The proportion of patients with Hb levels maintained within the target range (>10 g/dL) during 8 weeks randomization phase were 58.1% and 71.4% in biosimilar EPO and originator EPO, respectively (p=0.60; NS). There were no significant difference in epoetin dose between the 2 groups, and there was no drug-related adverse event in either group. Conclusion: Hb level at >10 g/dL could be maintained for 8 weeks of treatment with both originator and biosimilar EPO (more consistent with originator EPO and more fluctuations with biosimilar EPO), with similar epoetin dose and no drug-related adverse event.References
Beiraghdar F, Panahi Y, Einollahi B, et al. Evaluation of a biosimilar recombinant alpha epoetin in the management of anemia in hemodialysis patients. Saudi Pharm J. 2015; 23(5): 544-8.
Harzallah A, Zouaghi K, Dridi A, et al. Therapeutic Efficacy of a biosimilar epoetin alfa in hemodialysis patients. Saudi J Kidney Dis Transpl. 2015;26(1):78-82.
NCPC (North China Pharmaceutical) International Corp. Featured products. 2018.
Locatelli F, Pisoni RL, Combe C, et al. Anemia in haemodialysis patients of five European countries: association with morbidity and mortality in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol. Dial. Transplant. 2004;19:121-32.
Schmid H, Schiffl H. Erythropoiesis stimulating agents and anaemia of end-stage renal disease. Cardiovasc Hematol Agents Med Chem. 2010;8(3):164-72.
Shahani S, Braga-Basaria M, Maggio M, Basaria S. Androgens and erythropoiesis: past and present. J Endocrinol Invest. 2009;32:704-16.
Goh BL, Ong LM, Sivanandam S, Lim TO, Morad Z. Randomized trial on the therapeutic equivalence between Eprex and GerEpo in patients on haemodialysis. Nephrol. 2007;12:431-6.
Baltar J, Moran N, Ortega F, Rebollo P, Cofan F, Campistol JM. Erythropoietin safety and efficacy in chronic allograft nephropathy. Transpl Proc. 2007;39:2245-7.
London G, Mann J, Goldsmith D, et al. Long term treatment with biosimilar epoetin-a (HX575) in hemodialysis patients with renal anemia: real-world effectiveness and safety in the MONITOR-CKD5 study. Clinical Nephrology. 2018;89(1):1-9.
Stoppa G, D’Amore C, Conforti A, et al. Comparative safety of originator and biosimilar epoetin alfa drugs: an observational prospective multicenter study. Bio Drugs. 2018;32:367-75.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The authors who publish in this journal agree to the following requirements:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
Privacy Statement
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.