dcsimg Aranesp® (darbepoetin alfa) – Erythropoiesis

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Aranesp® stimulates RBC production

  • It takes approximately 26 days for a stem cell to develop into a mature RBC.1-3
  • Erythropoietin is needed for RBC production.1-3
  • Once stimulated by erythropoietin, it takes approximately 8 days to form a reticulocyte.2
  • As RBCs accumulate, hemoglobin (Hb) will increase.4

Impaired kidney function may impede RBC production

  • Patients with CKD have decreased erythropoietin production.4
  • Evaluate iron status in all patients before and during Aranesp® treatment and maintain iron repletion.
Hypothetical model of the response to Aranesp®

Hb response to treatment may take between 2 and 6 weeks
after initiating therapy.5

Important Safety Information

  • Aranesp® increases the risk of seizures in patients with CKD. Monitor patients closely for new-onset seizures, premonitory symptoms, or change in seizure frequency.
  • For lack or loss of hemoglobin response to Aranesp®, initiate a search for causative factors. If typical causes of lack or loss of hemoglobin response are excluded, evaluate for PRCA.

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Important Safety Information.

Abbreviations and References:
CKD = chronic kidney disease; RBC = red blood cell.
References: 1. Papayannoulou T, D’Andrea AD, Abkowitz JL, Migiliaccio A. In: Hoffman R, Benz EJ, Shattil SJ, et al, eds. Hematology: Basic Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2005:267-294. 2. Dessypris EN. In: Lee GR, Foerster J, Lukens J, Wintrobe MM, eds. Wintrobe’s Clinical Hematology. Philadelphia, PA: Lippincott Williams & Wilkins;1998:169-192. 3. Bunn H. In: Isselbacher KJ, Wilson JD, Braunwald E, eds. Harrison’s Principles and Practice of Internal Medicine. 13th ed. New York, NY: McGraw-Hill; 1994:1717-1721. 4. Guyton AC, Hall JE. In: Textbook of Medical Physiology. 11th ed. Philadelphia, PA: Elsevier Saunders; 2006:419-428. 5. Aranesp® (darbepoetin alfa) prescribing information, Amgen. 6. Sargent JA, Acchiardo SR. Iron requirements in hemodialysis. Blood Purif. 2004;22:112-123. 7. Uehlinger DE, Gotch FA, Sheiner LB. A pharmacodynamic model of erythropoietin therapy for uremic anemia. Clin Pharmacol Ther. 1992;51:76-89.