A multicentre, multi-national, double-blind, randomised, active-controlled, parallel-group clinical study to assess the safety and efficacy of PDA10 (Epoetin-alpha) vs. Eprex® in patients with anaemia of chronic renal failure

Navigating the Global Economic Landscape of Dialysis: A Summary of Expert Opinions from The 4th International Congress of Chinese Nephrologists

Background

Chronic kidney disease (CKD) continues to be a significant global public health issue. The escalating burden of CKD is probably driven by the aging population and the rising prevalence of diabetes. CKD not only adversely impacts an individual's health and well-being, but also poses significant challenge on the economy of the society.

Summary

Experts from ten countries and regions around the world (Australia, Canada, China, Hong Kong, Malaysia, New Zealand, Singapore, Taiwan, United Kingdom, and United States) convened in the 4th International Congress of Chinese Nephrologists on December 1, 2023 to discuss the global dialysis burden. Although the cost of kidney replacement therapy (KRT) accounts for 2-3% of total healthcare expenditure in developed countries, patients with end stage kidney disease (ESKD) only represent a small percentage (<0.5%) of the population. Importantly, the economic impact of ESKD is not limited to direct medical costs, but extends to indirect societal costs, such as productivity loss by patients and caregivers. Primary prevention of CKD, early screening and treatment to delay progression to ESKD (where treatment costs rise dramatically), and utilization of home-based dialysis therapy (including peritoneal dialysis and home hemodialysis) shall be implemented as part of cost-containment strategy. Kidney transplant provides better outcomes than dialysis and is cost-effective in long run, whereas conservative kidney management should be considered for elderly frail patients.

Key Messages

Implementation of preventive measures and cost-effective treatment strategies are the cornerstone to combat the global CKD epidemic.

Comparative Study of Recombinant Human Erythropoietin (rhEPO) Products on CKD (Chronic Kidney Disease) Patients

PURPOSE

This study was conducted to evaluate whether the efficacy and safety profile of recombinant human erythropoietin (rhEPO) manufactured by Daewoong Pharmaceutical Co., Ltd was similar to biological products approved by the drug safety regulatory authority.

PATIENTS AND METHODS

It was an open-label, randomized, comparative, parallel, multi-center study in hemodialysis patients with anemia. The reference product at an individualized dose 3 times a week was given in 4-8 weeks of titration period and hemoglobin (Hb) level was controlled to reach the range of 10-12 g/dL. Then, the subjects were randomly administered with reference or test product with the same dose regimen. The primary endpoints were to demonstrate the Hb level change between baseline and evaluation period in both treatment groups, while the secondary endpoints were the mean change in weekly dosage per kg body weight and the instability rate of Hb level during maintenance and evaluation period. The safety was evaluated based on the adverse events incidence.

RESULTS

There was no statistical difference in the change of Hb between test and reference (0.14 g/dL and 0.75 g/dL respectively, with p>0.05), also for the mean changes of weekly dosage between groups (1091.40 IU and 570.15 IU respectively, with p>0.05). The instability rate of Hb in both test and reference was not statistically significantly different as well (26 and 15% respectively, with p>0.05).

CONCLUSION

This study proves that the efficacy indicated by the change instability of Hb and safety indicated by adverse event incidence of Epodion and the reference product on chronic kidney disease were similar.