Packaging Type: Injection. By definition, the DCR could not be calculated for patients ineligible for the DCR analysis as these did not have the necessary parameters recorded in both EPs. BlandAltman analysis of agreement between pre- and post-switch erythropoiesis-stimulating agent dose (n=205). This suggests that the decision to transfuse was consistent with respect to Hb over the observation period (Fig. AFFIRM demonstrated non-linearity of the dose relationship curve, with DCR decreasing as pre-switch DA dose increased. Aranesp (darbepoetin alfa) | Dosing Considerations Results: (PDF) Conversion from epoetin beta to darbepoetin: What is the The primary outcome measure, the geometric mean maintenance DCR, was calculated to be 1.17 (95% CI 1.05, 1.29). Visit. endobj DCR geometric mean maintenance dose conversion ratio, EP evaluation period, ESA erythropoiesis-stimulating agent, Hb hemoglobin, PEG-Epo methoxy polyethylene glycol-epoetin beta. . <> An observational cohort study of extended dosing (once every 2 weeks or once monthly) regimens with darbepoetin alfa in patients with chronic kidney disease not on dialysis: the EXTEND study. The .gov means its official. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Cochrane Database Syst Rev. Correct or exclude other causes of anemia (e.g., vitamin deficiency, metabolic or chronic inflammatory conditions, bleeding, etc.) A Study Comparing Mircera and Epoetin Alfa for the Treatment of Anemia Mircera solution for injection in pre-filled syringe - Summary of Administer supplemental iron therapy when serum ferritin is less than 100 mcg/L or when serum transferrin saturation is less than 20%. -. Department of Nephrology, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305, Australia, Amgen (Europe) GmbH, Dammstrasse 23, P.O. Methoxy polyethylene demonstrated that the dose efficiency after SC and IV ad- glycol-epoetin b (PEG-epoetin b; Mircera; F. Hoffmann- ministration was . species. OZZ DA, launched in 2001 [5, 7], contains 5 N-linked oligosaccharide chains, rather than the 3 contained in short-acting epoetins, which confer an approximately threefold longer serum half-life and mean residence time, allowing extended inter-dosing intervals [6]. PubMed PDF Limitations of Use Mircera is not indicated and is not recommended for Hymes J, Bickimer T, Jackson JH, Bookhart BK, Mody SH, Tak Piech C. Curr Med Res Opin. 2). In recent years, the trend has been to use higher doses of epoetin alfa (eg, 60,000 U once per week), recognizing that MDS RBC precursors may have relative intrinsic resistance to EPO. In order to compare stable clinical scenarios for the purposes of DCR calculation, data evaluation periods (EPs) were utilized: Months 2 and 1 were defined as the pre-switch EP and Months +6 and +7 were defined as the post-switch EP. Nephrol Dial Transplant. "BG0RjI G78 Discard any unused portion. Read reviews from GoodRx users who have taken Mircera and find the latest news on the drug. MIRCERA [prescribing information]. Medically reviewed by Drugs.com. Blistering and skin exfoliation reactions including Erythema multiforme and Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN), have been reported in patients treated with ESAs (including Aranesp, Serious and fatal reactions including gasping syndrome can occur in neonates and infants treated with benzyl alcohol-preserved drugs, including EPOGEN. Excluding patients receiving a transfusion within 90days of or during either EP, the DCR was 1.21 (95% CI 1.09, 1.35). EP evaluation period, PEG-Epo methoxy polyethylene glycol-epoetin beta. Data were collected from 7 months before until 7 months after switching treatment. 2 0 obj Analysis of relationship between pre- and post-switch erythropoiesis-stimulating agent dose. Karaboyas A, Morgenstern H, Fleischer NL, Vanholder RC, Dhalwani NN, Schaeffner E, Schaubel DE, Akizawa T, James G, Sinsakul MV, Pisoni RL, Robinson BM. before initiating Mircera [see Warnings and Precautions (5.9)]. Tolman et al. The intravenous route is recommended for patients on hemodialysis because the intravenous route may be less immunogenic. Of 302 patients enrolled, 206 had data available for DCR analysis. In controlled trials, patients experienced greater risks for death, serious adverse cardiovascular reactions, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target a hemoglobin level of greater than 11 g/dL. Before This analysis indicated that the concordance decreased with increasing dose. Methoxy polyethylene glycol-epoetin (Mircera ) will be increased and decreased in 1-step or 2-step increments, based on scale above. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in Maintenance treatment of renal anaemia in haemodialysis patients with methoxy polyethylene glycol-epoetin beta versus darbepoetin alfa administered monthly: a randomized comparative trial. Resistance to Erythropoiesis-Stimulating Agents among Patients on Hemodialysis Is Typically Transient. Fewer than half of the patients achieved Hb in the 1012g/dL range by 7months post-switch. RETACRIT Dosage Forms and Strengths (epoetin alfa-epbx) pediatric patients 5 to 17 years of age on hemodialysis who are converting from another ESA after their hemoglobin level was stabilized with an ESA. Association of kidney function with anemia: the Third National Health and Nutrition Examination Survey (19881994). Decreases in dose can occur more frequently. Generic name: Methoxy polyethylene glycol-epoetin beta 30ug in 0.3mL Prise en charge anmie rnale - Nephro.blog As shown in Tables2 and 3, the mean (standard error) monthly Hb remained stable across the observation period, with mean monthly concentration ranging from 11.42 (0.09) g/dL (Month 4) to 11.60 (0.09) g/dL (Month 2) pre-switch, and from 11.26 (0.10) g/dL (Month 4) to 11.67 (0.09) g/dL (Month 1) post-switch. Tables2 and 3 also summarize the proportion of patients in different Hb categories by study month. Conversion from Epoetin alfa or Darbepoetin alfa to Mircera in Adult Patients with CKD Mircera can be administered once every two weeks or once monthly to patients whose hemoglobin has been stabilized by treatment with an ESA (see Table 1). Anemia of end-stage renal disease (ESRD). The pre-transfusion Hb concentrations were similar for transfusions occurring both pre- and post-switch (Fig. An official website of the United States government. Not all pack sizes may be marketed. More severe cases were recorded with long-acting agents (darbepoetin alfa and methoxy polyethylene glycol-epoetin beta). and transmitted securely. RBC transfusions were reported in terms of number of transfusions and number of units transfused, using descriptive statistics. Aranesp (darbepoetin alfa) prescribing information, Amgen. Amgen Wins Patent Battle Over Roche's Anemia Drug 2020 Mar 26;2(3):286-296. doi: 10.1016/j.xkme.2020.01.007. official website and that any information you provide is encrypted doi: 10.1053/j.ajkd.2011.11.013. Administer MIRCERA intravenously once every 4 More ways to get app. Mircera Injection (Methoxy Polyethylene Glycol-Epoetin Beta ) 6,610/ Piece Get Latest Price. Conversion Dosing Guide: from Epoetin Alfa to Aranesp in Patients with The geometric mean DCR of PEG-Epo to DA was 1.17, rising to 1.21 when the effect of RBC transfusions was taken into account. Anemia Associated with Chronic Renal Failure, Methoxy polyethylene glycol-epoetin beta 30ug in 0.3mL, Drug class: recombinant human erythropoietins. Methoxy polyethylene glycol-epoetin beta injection causes the . . 1:1 reference line indicates equal PEG-Epo and darbepoetin alfa doses. Composition: Methoxy Polyethylene Glycol-Epoetin Beta. When a patient with a darbepoetin (Aranesp) or erythropoietin order switches to . PubMed reverse transcriptase polymerase chain reaction (RT-PCR) Amplification of RNA sequences by conversion to cDNA by nucleic acid hybridization A technique of nucleic acid reverse transcriptase, followed by the polymerase chain reac-analy sis via association of complementary single- stranded tion. HQ-MIR-1900027 Site last modified: January 2023. PDF Anemia response to Methoxy Polyethylene Glycol-Epoetin Beta (Mircera aranesp to retacrit conversion Methoxy polyethylene glycol-epoetin beta injection is used to treat anemia in adults with chronic kidney disease (CKD) who may or may not be on dialysis or in children with CKD who are on dialysis. Mircera is used to reduce or avoid the need for RBC transfusions. methoxypolyethylene glycol-epoetin beta (meh-thok-see-pah-lee-eh-thih-leen gly-kol ee-poh-eh-tin bay-ta) , Mircera (trade name) Classification Therapeutic: antianemics Pharmacologic: hormones Pregnancy Category: C Indications Anemia due to chronic renal failure. This was particularly evident in patients whose pre-switch EP weekly DA dose was higher than 100g. Excluding patients receiving a transfusion within 90 days of or during either EP, the DCR was 1.21 (95% CI 1.09, 1.35). Bland JM, Altman DG. %PDF-1.7 HHS Vulnerability Disclosure, Help | DOWNLOAD SIZE: A total of 302 eligible patients were enrolled at 14 European hemodialysis centers, with 57% of patients enrolled at 10 French sites, 18% at 2 Spanish sites, 17% at 1 UK site, and 8% at 1 German site. Do you wish to proceed? Table 1 Mircera Starting Doses for Adult Patients Currently Receiving an ESA, Table 2 Mircera Starting Doses for Pediatric Patients Currently Receiving an ESA. The remaining enrolment was at four sites divided between three other countries. Physicians and patients should weigh the possible benefits of decreasing transfusions against the increased risks of death and other serious cardiovascular adverse events. Do not use the prefilled syringe more than once. However, the relationship between the pre- and post-switch ESA doses during the two evaluation periods was non-linear. Dr. Gerald Diaz @GeraldMD. This article does not contain any studies with human or animal subjects performed by any of the authors. Methoxy polyethylene glycol-epoetin beta, the active substance of MIRCERA, is a continuous erythropoietin receptor activator that shows a different activity at the receptor level characterized by a slower association to and faster dissociation from the receptor, a reduced specific activity in vitro with an increased activity in vivo, as well as an increased half-life, in contrast to . Mechanism of Action. EPOGEN (epoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD) in patients on dialysis to decrease the need for red blood cell (RBC) transfusion. x]r9r}W#k aMutually exclusive categories; patients are censored in the following order: first at death post-switch, then at loss to follow-up post-switch, then at receipt of an ESA other than PEG-Epo, and finally lack of an Hb measurement in either or both EPs. Results of the BlandAltman analysis investigating the concordance between mean weekly ESA doses in both evaluation periods are presented in Fig. Data on clinical and laboratory parameters relating to CKD management were abstracted from patient records and entered into an anonymized study-specific central database by study center staff. https://doi.org/10.1007/s12325-013-0063-y, DOI: https://doi.org/10.1007/s12325-013-0063-y. Pure red cell aplasia (PRCA) that begins after treatment with Mircera or other erythropoietin protein drugs. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. 3. There is no evidence that Mircera alters the metabolism of other medicinal products. Methods: The number of transfusions and units transfused increased approximately threefold from the pre-switch to the post-switch period. in the treatment of anemia due to cancer chemotherapy. No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Peter Choi. Mircera works like the human protein called erythropoietin to help your body make more RBCs. Epub 2022 Apr 22. Le bilan martial est dpendant de l'tat inflammatoire et la protine C ractive (CRP) est galement suivi tous les 3 mois pour cela. ^D[5j@%e Please know that Amgen, the sponsor of this site, is not responsible for the content on the site you are about to enter. Mircera | European Medicines Agency In the absence of PRCA, follow dosing recommendations for management of patients with an insufficient response to MIRCERA, Cases of PRCA and of severe anemia, with or without other cytopenias that arise following the development of neutralizing antibodies to erythropoietin have been reported in the postmarketing setting in patients treated with MIRCERA, PRCA has also been reported in patients receiving ESAs for anemia related to hepatitis C treatment (an indication for which MIRCERA, If severe anemia and low reticulocyte count develop during treatment with MIRCERA, Serious allergic reactions, including anaphylactic reactions, angioedema, bronchospasm, tachycardia, pruritus, skin rash and urticaria have been reported in patients treated with MIRCERA, Blistering and skin exfoliation reactions including Erythema multiforme and Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN), have been reported in patients treated with ESAs (including MIRCERA, Patients may require adjustments in their dialysis prescription after initiation of MIRCERA, Most frequent adverse reactions ( 5%) in adult patients with CKD treated with MIRCERA. The aims of the Aranesp Efficiency Relative to Mircera (AFFIRM) study were primarily to estimate the maintenance dose conversion ratio (DCR) of PEG-Epo to DA in a population of European hemodialysis patients switched from DA to PEG-Epo and with comparable mean hemoglobin (Hb) in the pre- and post-switch periods, and secondarily to investigate Article When initiating or adjusting therapy, monitor hemoglobin levels at least weekly until stable, then monitor at least monthly. doi: 10.1038/ki.1985.109. Waiting game continues with Mircera launch | Evaluate Following administration, remove the needle from the injection site and then release the plunger to allow the needle guard to move up until the entire needle is covered. This medicine is not used to treat anemia caused by cancer medicines. Mircera is not the same as epoetin alfa (Procrit, Epogen). 1. Using ESAs to target a hemoglobin level of greater than 11 g/dL increases the risk of serious adverse cardiovascular reactions and has not been shown to provide additional benefit. Drug class: Recombinant human erythropoietins. The majority of patients who were transfused during the pre- and post-switch observation periods had Hb 10g/dL within the 14days prior to transfusion; only 1 patient during each period had Hb >11g/dL within the 14-day pre-transfusion interval. a Mutually exclusive categories; patients are censored in the following, Analysis of relationship between pre- and post-switch erythropoiesis-stimulating agent dose. If Hb increases by < 1 g/dL and remains < 10 g/dL after 6 weeks of therapy: If dosing QW, then increase dose to 4.5 mcg/kg/week. government site. 1: 21% of the excluded patients had died or were lost to follow-up during the post-switch period; 45% were no longer receiving PEG-Epo by Months +6 and +7 post-switch; and 34% had no Hb value reported for one or both EPs. A BlandAltman analysis [10] was also performed to assess the agreement between ESA doses in the evaluation periods. Kazmi WH, Kausz AT, Khan S, et al. At the moment forecasts for Mircera are $345m in 2015 rising to $552m in 2020, reflecting sales made outside the US. Mean Hb was 11.5 g/dL in the pre-switch EP and 11.4 g/dL in the post-switch EP. Hemoglobin level and weekly equivalent erythropoiesis-stimulating agent dose during the 14-month observation period. If the hemoglobin rises rapidly (e.g., more than 1 g/dL in any 2-week period), reduce the dose of MIRCERA. The aims of the Aranesp Efficiency Relative to Mircera (AFFIRM) study were primarily to estimate the maintenance dose conversion ratio (DCR) of PEG-Epo to DA in a population of European hemodialysis patients switched from DA to PEG-Epo and with comparable mean hemoglobin (Hb) in the pre- and post-switch periods, and secondarily to investigate parameters of clinical management of anemia in this group of patients, in real-world clinical practice. Nephrol Dial Transplant. Of 302 patients enrolled, 206 had data available for DCR analysis. Drugs. . % For adverse event reports, please contact us at safety@viforpharma.com,mircera@viforpharma.com or at 1-800-576-8295. Please click the OK button below to continue. MIRCERA Dosage & Rx Info | Uses, Side Effects - MPR American Society of Hematology Self-Assessment Program (Adam - Scribd Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. Amgen Business Review November 7, 2008 Strategic Outlook Kevin Sharer CEO 3 Provided November 7, 2008 as part of an oral presentation and is qualified by such, contains forward-looking Conversion Dosing Guide: From epoetin alfa to Aranesp in patients with anemia due to CKD on dialysis. See Instructions for Use for complete instructions on the preparation and administration of MIRCERA, If the hemoglobin level approaches or exceeds 11 g/dL, reduce or interrupt the dose of MIRCERA. Conversion from epoetin beta to darbepoetin: what is the equivalent Conversion from Another ESA: dosed once monthly or once every two weeks based on total weekly epoetin alfa or darbepoetin alfa dose at time of conversion (2.2). ou toutes les 2 semaines (ou par mois en prdialyse) la dose requise Avant 1 an : non indiqu 11 ans : comme chez l'adulte MIRCERA (potine bta - MPG [mthoxy-polythylne glycol]) 1 injection mensuelle la dose requise Non indiqu Mircera belongs to a class of drugs called Hematopoietic Growth Factors. Nephrol Dial Transplant. ONLY administer MIRCERA intravenously in pediatric patients. Last updated on Jul 26, 2022. The relationship between the DA and PEG-Epo doses during the evaluation periods was explored through linear and quadratic regression. Appropriately control hypertension prior to initiation of and during treatment with MIRCERA, Seizures have occurred in patients participating in MIRCERA, For lack or loss of hemoglobin response to MIRCERA, If typical causes of lack or loss of hemoglobin response are excluded, evaluate for PRCA. Conclusion: A dose approximating 0. Aranesp (darbepoetin alfa) is indicated for the treatment of anemia due to chronic kidney disease (CKD), including patients on dialysis and patients not on dialysis. Show detailed description Study Design Go to There were 16 transfusion events in the pre-switch period and 48 post-switch, with a total of 34 units transfused pre-switch and 95 units in the post-switch period (Fig. Pharmacotherapy Update - Automatic Therapeutic Interchange Program 2010;25:400917. reaction occurs. Clin Kidney J. Longer-acting PEG-Epo contains a chemical bond between an amino group present in epoetin beta and methoxy polyethylene glycol (PEG) butanoic acid; the addition of PEG is responsible for an increase in serum half-life of epoetin beta, and in CKD patients on dialysis the terminal half-life of PEG-Epo after IV administration is 134h [6, 8]. The AFFIRM study was designed as a retrospective, longitudinal cohort analysis to estimate the DCR in a population of hemodialysis patients achieving comparable Hb after switching from IV DA to IV PEG-Epo in a real-world setting. Methoxy polyethylene glycol-epoetin beta - Wikipedia Geometric mean weekly PEG-Epo dose at Month 1 post-switch was 26.7g (95% CI 24.4, 29.3), rising to 29g (95% CI 26.2, 32.2) by Month 7 post-switch. Dr. Peter Choi is the guarantor for this article, and takes responsibility for the integrity of the work as a whole. Google Scholar. Response rates are defined in two ways: 1) Hgb levels > 12 g/dL or 2) an increase in Hgb of 2 g/dL from baseline. Mircera is administered by subcutaneous (SC) or intravenous (IV) injection (2.2). <>/Metadata 444 0 R/ViewerPreferences 445 0 R>> Eschbach JW, Adamson JW. About ARANESP (darbepoetin alfa) | Amgen ESA | HCP Injection: 2,000 Units/mL, 3,000 Units/mL, 4,000 Units/mL, 10,000 Units/mL, and 40,000 Units/mL of RETACRIT as a clear and colorless liquid in single-dose vials. Patients with CKD and an insufficient hemoglobin response to ESA therapy may be at even greater risk for cardiovascular reactions and mortality than other patients. All calculations should be confirmed before use. Patients stable on intravenous (iv) epoetin alfa will be randomized either to receive standard of care therapy (epoetin alfa (iv) 3 times weekly), or to receive Mircera 120-360 micrograms (iv), monthly. Am J Kidney Dis. For lack or loss of hemoglobin response to Aranesp or EPOGEN, initiate a search for causative factors. Epub 2020 Aug 20. before initiating MIRCERA. Editorial assistance in the preparation of this manuscript was provided by W. Mark Roberts, PhD, Montreal, Canada. Values are means (arithmetic for hemoglobin, geometric for dose) with 95% confidence intervals. Once the hemoglobin has been stabilized, MIRCERA, If the hemoglobin level exceeds 10 g/dL, reduce or interrupt the dose of MIRCERA. Do not use any prefilled syringes exhibiting particulate matter or a coloration other than colorless to slightly yellowish. No test of statistical significance was performed on any of the clinical characteristics. The geometric mean weekly ESA doses were 24.1 g DA in the pre-switch EP and 28.6 g PEG-Epo in the post-switch EP. maintains stable haemoglobin levels in patients on dialysis previously treated with darbepoetin alfa: results from STRIATA, a randomized phase III study. In controlled clinical trials, ESAs increased the risk of death in patients undergoing coronary artery bypass graft surgery (CABG) and the risk of deep venous thrombosis (DVT) in patients undergoing orthopedic procedures. Pure red cell aplasia (PRCA) that begins after treatment with MIRCERA, History of serious or severe allergic reactions to MIRCERA. Aranesp Dosing Calculator75 mcg/kg as an IV or SC injection once every Active ingredient: methoxy polyethylene glycol-epoetin beta Inactive ingredients: mannitol, methionine, poloxamer 188, sodium phosphate monobasic monohydrate, and sodium sulfate. as a substitute for red blood cell transfusions in patients who require immediate correction of anemia. Patients were then switched to fortnightly darbepoetin alfa dosing treatments; the existing weekly dose being doubled and Hb levels fell from 125 to 110 g/L (P < 0.0001), despite an increase in the mean dose from 44.9 to 47.5 . PubMedGoogle Scholar. Section III: Treatment of renal anaemia. The study comprised a 14-month observation period. Red blood cell transfusions pre- and post-switch were quantified. 2001;38:803812. aranesp to retacrit conversiontuto amigurumi grenouille au crochet. Statistical methods for assessing agreement between two methods of clinical measurement. Usui T, Zhao J, Fuller DS, Hanafusa N, Hasegawa T, Fujino H, Nomura T, Zee J, Young E, Robinson BM, Nangaku M. Nephrology (Carlton). Each dosage strength of MIRCERA is designated by a unique syringe plunger color. Dose Conversion Ratio in Hemodialysis Patients Switched from 2004;19(Suppl 2):ii1631. Hemoglobin level and weekly equivalent erythropoiesis-stimulating agent dose during the 14-month observation period. Further exploration of the relationship between DA and PEG-Epo doses using the BlandAltman method [10], which circumvents the limitations of the regression method in this type of investigation, indicated that the variability in the dose differences increased as doses increased, while the level of concordance decreased with increasing ESA dose. m+KqXAXOkS@,1C0VgzXzeWU},4 New anemia therapies: translating novel strategies from bench to bedside. The study sample comprised adult patients (age 18years) with CKD who received maintenance hemodialysis between January 2008 and August 2011 and whose ESA treatment was switched from IV DA to IV PEG-Epo. ARANESP single-dose strengths can be combined 4,* You can more . Mircera will be administered IV to HD patients, and SC to PD patients. In controlled clinical trials, ESAs increased the risk of death in patients undergoing coronary artery bypass graft surgery (CABG) and the risk of deep venous thrombosis (DVT) in patients undergoing orthopedic procedures. MIRCERA (methoxy polyethylene glycol-epoetin beta) is the first erythropoiesis-stimulating agent (ESA) approved by FDA for once-monthly administration. randomized patients to darbepoetin or epoetin beta once weekly after the patients had been treated with epoetin beta three times weekly. Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis. 3. risks. In these hemodialysis patients switched from DA to PEG-Epo the DCR was 1.17 and 1.21 after accounting for the effect of transfusions. Individual patients could contribute multiple transfusions to these analyses. 8600 Rockville Pike (0.6MB), Anemia Assessment and Management Brochure, Pathophysiology of Anemia in Patients with CKD, * Case studies and patient profiles are hypothetical, WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS AND TUMOR PROGRESSION OR RECURRENCE. [3] It is the first approved, chemically modified erythropoiesis-stimulating agent (ESA). Mircera with 1-step decrease as soon as Hgb is < 11.8 g/dL and last dose was administered 2 weeks ago or more. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. St. Gallen, Switzerland: Vifor (International) Inc.; June 2018. We comply with the HONcode standard for trustworthy health information. MIRCERA is contraindicated in patients with: Please seefull Prescribing Information including Boxed WARNING, and Medication Guide(English, Espaol)for MIRCERA (methoxy polyethylene glycol-epoetin beta) Injection, for Intravenous or Subcutaneous Use. Macdougall IC, Obrador GT, El Nahas M. How important is transfusion avoidance in 2013? Accounting for the effect of transfusion, the DCR was 1.21 (95% CI 1.09, 1.35).
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mircera to aranesp conversion