Erithropoyesis stimulating agents

Abstract

Anemia, constitute one of the important markers for the mortality and morbidity of end stage renal failure patients, either in the pre-dialytic, as in the dialytic period.
The early and adequate treatment of this entity is major goal in those patients, in order to provide them a better survival.
The Erythropoiesis Stimulating Agents (ESA), as well an optimum iron management enhance the haemoglobin stability.
As Erythropoietin is the most important agent in the treatment of anaemia related with end stage renal failure, it became necessary to the biotechnology to develop a virtually identical molecule. In this article we review, several erythropoietin stimulating agents. Although their similar pharmacologic action, they are chemically different. The first ESA was the Human Recombinant Erythropoietin, with a short half life and tri seminal schedule doses, either intravenous, or subcutaneous.
Most recently, Erythropoietin Analogue (Alfa Darbepoetin) through variations in the molecule glycosylation pattern provides a much longer half life, making possible one or two doses weekly.
The introduction of the new, Continuous Erythropoietin Receptor Activator (CERA), demonstrate that the haemoglobin stability is achieve with a monthly single doses. Other group, the Synthetic Erythropoietin Receptor Agonist (Hematide), actually in phase I experimental studies can be used monthly as well but intravenous.