Epoetin Alfa Versus Darbepoetin Alfa in Chemotherapy-Related Anemia

PharmaCE- Continuing Education


OBJECTIVE: To review and compare the data concerning the clinical activity of epoetin alfa versus darbepoetin alfa when
administered to patients with cancer who are experiencing treatment-related anemia.

DATA SOURCES: English-language publications from the MEDLINE database (1990-June 2005), published articles, and meeting
abstracts were reviewed.

STUDY SELECTION AND DATA EXTRACTION: Relevant data were extracted from published reports and abstracts on studies
of humans with cancer who developed treatment-related anemia and were treated with epoetin alfa or darbepoetin alfa.

DATA SYNTHESIS: Epoetin alfa and darbepoetin alfa are similar agents with identical indications for treatment of anemia in patients with cancer. Clinical trials have demonstrated that both agents can significantly improve hemoglobin levels, reduce transfusion requirements, and improve quality of life. Epoetin alfa is approved for administration at a dose of 150 units/kg subcutaneously 3 times per week, and darbepoetin alfa is approved for administration at a dose of 2.25 units/kg once a week. Clinical studies have demonstrated that epoetin alfa may be administered at 40 000 units once a week and that darbepoetin alfa may be administered at 200 µg every 2 weeks without loss of efficacy. Cost analysis, based on the average wholesale price of each drug alone administered for 12 weeks at Food and Drug Administration-approved doses, revealed that epoetin alfa is less expensive than darbepoetin alfa. When they are administered in the extended schedules, the cost of darbepoetin alfa is slightly less than that of epoetin alfa. However, the total expense associated with the extended schedule of either agent is further reduced by a reduction in other costs associated with drug administration.

CONCLUSIONS: Epoetin alfa and darbepoetin alfa have identical indications for treatment of anemia in patients receiving cancer
chemotherapy. Clinical trials have demonstrated similar activities with both agents. Darbepoetin alfa, with a longer half-life, can be
dministered less frequently, saving costs as well as reducing patient office visits.

Key Words: anemia, chemotherapy, darbepoetin, epoetin

Published Online, December 6, 2005. www.theannals.com, DOI 10.1345/aph.1G042

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-06-001-H01

PharmaCE^TM
is a service of HARVEY WHITNEY BOOKS COMPANY
8044 Montgomery Road, Suite 415, Cincinnati, OH 45236-2919
P.O. Box 42696, Cincinnati, OH 45242-0696 USA
Toll Free: 877/742-7631
Tel. 513/793-3555, FAX 513/793-3600
Office Hours: Monday - Friday 9-5 E.S.T.
Contact Us
All Rights Reserved. Copyright © 1998-