# Short versus long-acting erythropoiesis-stimulating agents for anemia management in Egyptian hemodialysis patients

## TL;DR

This study compares short- and long-acting anemia treatments for Egyptian dialysis patients, finding the long-acting option more effective and cost-saving.

## Contribution

The study provides a novel comparative analysis of ESA effectiveness, safety, and cost in an Egyptian CKD population.

## Key findings

- Aranesp achieved target hemoglobin levels in 63.4% of patients versus 50.6% for Eprex.
- Aranesp was found to be cost-saving compared to Eprex.
- Both treatments had similar safety profiles.

## Abstract

Background: Chronic kidney disease (CKD) often results in renal anemia, impacting the well-being of patients and causing various negative consequences. Erythropoiesis-stimulating agents (ESAs) offer promising solutions for managing anemia in CKD. This study aimed to evaluate and compare the effectiveness, safety profile, and cost-effectiveness of short-acting (Eprex®) and long-acting (Aranesp®) ESAs.

Method: This comparative prospective cohort cost-effectiveness study was carried out over 6 months among adult Egyptian hemodialysis patients of either gender. Participants were categorized into two groups based on the type of ESA administered: the Eprex group, receiving epoetin alfa, and the Aranesp group, receiving darbepoetin alfa. These two treatment groups’ efficacy, safety, and cost were analyzed and compared.

Results: Of 127 hemodialysis patients, 60 (47.2%) received Eprex, while 67 (52.8%) were treated with Aranesp. Target hemoglobin (Hb) was achieved by 50.6% of patients in the Eprex group versus 63.4% in the Aranesp group, with a significant difference (P < 0.001). Both treatment groups exhibited a similar safety profile, while Aranesp® was considered the cost-saving protocol.

Conclusion: In hemodialysis Egyptian patients, Aranesp with extended dosing intervals proved to be more effective in achieving target Hb with comparable adverse effect profiles, a substantial cost-saving strategy, and offered time-saving advantages for medical staff workload compared to Eprex.

Trial registration: The Clinicaltrial.gov registration ID is NCT05699109 (26/01/2023).