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Novel Erythropoiesis-Stimulating Agents: A New Era in Anemia Management

Department of Renal Medicine, King's College Hospital, London, United Kingdom

Correspondence: Dr. Iain C. Macdougall, Renal Unit, King's College Hospital, London SE5 9RS, UK. Phone: ++44-203-299-9000, ext. 6953; Fax: ++44-207-346-6472; E-mail: Iain.macdougall{at}kch.nhs.uk

Nearly two decades ago, recombinant human erythropoietin transformed the management of chronic kidney disease anemia by allowing a more sustained increase in hemoglobin than was possible by intermittent blood transfusion. The treatment was highly effective, but because of the fairly short half-life of the molecule at approximately 6 to 8 h, injections usually had to be administered two to three times weekly. A second-generation erythropoietin analogue, darbepoetin alfa, was then created, with a longer elimination half-life in vivo that translated into less frequent dosing, usually once weekly or once every 2 wk. More recently, another erythropoietin-related molecule has been produced called Continuous Erythropoietin Receptor Activator with an even greater half-life, and other molecules are in development or are being licensed, including biosimilar epoetin products and Hematide. The latter is a synthetic peptide-based erythropoietin receptor agonist that, interestingly, has no structural homology with erythropoietin, and yet is still able to activate the erythropoietin receptor and stimulate erythropoiesis. The search goes on for orally active antianemic therapies, and several strategies are being investigated, although none is imminently available. This article reviews the latest progress with these novel erythropoietic agents in this new era in anemia management.

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Anemia of Chronic Kidney Disease

Ajay K. Singh
Clin. J. Am. Soc. Nephrol. 2008 3: 3-6. [Full Text] [PDF]

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				S. Summers, S. Holdsworth, and E. Sharples The (re-)challenging question of erythropoiesis-stimulating agents inducing pure red cell aplasia Nephrol. Dial. Transplant., June 16, 2008; (2008) gfn326v1. [Full Text] [PDF]

				A. K. Singh Anemia of Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 3 - 6. [Full Text] [PDF]