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Background <p>Administering darbepoetin (Darbe) to preterm infants stimulates erythropoiesis, increases red blood cell (RBC) mass, and reduces RBC transfusions. We typically administer 10 µg/kg weekly until 34 weeks corrected gestation; however, we are uncertain whether this dose could be given every <i>other</i> week (biweekly) with equal efficacy.</p> Methods <p>Infants ≤32 weeks were randomized to receive Darbe 10 µg/kg/dose weekly or biweekly for six weeks, tracking complete blood counts, absolute reticulocyte counts (ARC), iron status (RET-He), and RBC transfusions.</p> Results <p>We enrolled 71 infants (1027 ± 369 grams, 27.3 ± 2.8 weeks). During the study period, the weekly-dosed group had a higher adjusted mean ARC (48,000/μL higher, 95% C.I. 9700–87,000/μL; <i>p</i> = 0.019). However, RET-He, Hgb, and transfusion-free survival were not different between groups (<i>p</i> = 0.071, <i>p</i> = 0.244, and <i>p</i> = 0.762).</p> Conclusions <p>Weekly Darbe results in a higher six-week ARC than biweekly dosing. However, given similar clinical outcomes, perhaps biweekly dosing may be a cost-effective alternative.</p>

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A prospective randomized pilot trial comparing weekly vs. biweekly Darbepoetin administration to preterm infants

  • 期刊论文

  • 发表日期：

    2025年3月6日

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  • Timothy M. Bahr,
  • Robert D. Christensen,
  • Kimberlee A. Weaver-Lewis,
  • Danielle M. Scott,
  • Erick Gerday,
  • Jared J. Tuttle,
  • Robin K. Ohls

摘要

Background

Administering darbepoetin (Darbe) to preterm infants stimulates erythropoiesis, increases red blood cell (RBC) mass, and reduces RBC transfusions. We typically administer 10 µg/kg weekly until 34 weeks corrected gestation; however, we are uncertain whether this dose could be given every other week (biweekly) with equal efficacy.

Methods

Infants ≤32 weeks were randomized to receive Darbe 10 µg/kg/dose weekly or biweekly for six weeks, tracking complete blood counts, absolute reticulocyte counts (ARC), iron status (RET-He), and RBC transfusions.

Results

We enrolled 71 infants (1027 ± 369 grams, 27.3 ± 2.8 weeks). During the study period, the weekly-dosed group had a higher adjusted mean ARC (48,000/μL higher, 95% C.I. 9700–87,000/μL; p = 0.019). However, RET-He, Hgb, and transfusion-free survival were not different between groups (p = 0.071, p = 0.244, and p = 0.762).

Conclusions

Weekly Darbe results in a higher six-week ARC than biweekly dosing. However, given similar clinical outcomes, perhaps biweekly dosing may be a cost-effective alternative.