The Use of Darbepoetin to Stimulate Erythropoiesis in the Treatment of Anemia of Chronic Kidney Disease in Dogs

• Published in: Journal of veterinary internal medicine Vol. 31; no. 2; pp. 476 - 485
• Main Authors: Fiocchi, E.H., Cowgill, L.D., Brown, D.C., Markovich, J.E., Tucker, S., Labato, M.A., Callan, M.B.
• Format: Journal Article
• Language: English
• Published: United States John Wiley and Sons Inc 01.03.2017; Wiley
• Subjects: Anemia - drug therapy; Anemia - veterinary; Animals; Darbepoetin alfa - adverse effects; Darbepoetin alfa - therapeutic use; Dog Diseases - blood; Dog Diseases - drug therapy; Dogs; Erythropoiesis - drug effects; Erythropoietin; Female; Hematinics - adverse effects; Hematinics - therapeutic use; Hematocrit - veterinary; Iron; Male; Pure red cell aplasia; Red-Cell Aplasia, Pure - chemically induced; Red-Cell Aplasia, Pure - veterinary; Renal disease; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - veterinary; Retrospective Studies; SMALL ANIMAL; Renal disease; Iron; Erythropoietin; Pure red cell aplasia
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.14681

Background Darbepoetin alfa (darbepoetin) is an erythropoiesis‐stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking. Hypothesis/Objectives To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events. Animals Thirty‐three client‐owned dogs with naturally occurring CKD, including 26 with comorbidities. Methods Multi‐institutional retrospective study. Results The median starting dosage and highest dosage of darbepoetin administered were 0.5 and 0.8 μg/kg SC once weekly, respectively. Response to treatment was defined as achieving a packed cell volume (PCV) ≥30% or an increase in PCV ≥10%. Twenty‐eight of 33 dogs (85%) achieved a PCV ≥30% and 22 of 33 (67%) dogs achieved an increase in PCV ≥10%. Median time to achieve a PCV ≥30% was 29 days. A higher starting dosage was associated with achieving an increase in PCV ≥10% (P = .01). No dog sustained a response at a dosing interval >q21d. Potential adverse events included increased blood pressure requiring treatment (n = 12), seizures (n = 5), vomiting (n = 3), diarrhea (n = 3), and possible pure red cell aplasia (PRCA) (n = 2). Conclusions and Clinical Importance Darbepoetin, when combined with treatment of comorbidities, is an effective treatment for anemia secondary to CKD in dogs. A dosing interval >q21d was ineffective at maintaining a response to treatment. PRCA was a possible adverse event in 2 of 33 dogs (6%).