Дарбепоэтин альфа: Қан жасауға көмектесетін дәрі

Pharmaceutical drug

Darbepoetin alfa (INN) /d//ɑːr//b//ə/'/p//oʊ//ᵻ//t//ᵻ//n/ is a re engineered form of erythropoietin containing 5 amino acid changes (N30, T32, V87, N88, T90) resulting in the creation of 2 new sites for N linked carbohydrate addition. It has a 3 fold longer serum half life compared to epoetin alpha and epoetin beta. It stimulates erythropoiesis (increases red blood cell levels) by the same mechanism as rHuEpo (binding and activating the Epo receptor) and is used to treat anemia, commonly associated with chronic kidney failure and cancer chemotherapy. Darbepoetin is marketed by Amgen under the trade name Aranesp. The medication was approved in September 2001, by the US Food and Drug Administration for treatment of anemia in patients with chronic kidney failure by intravenous or subcutaneous injection. In June 2001, it had been approved by the European Medicines Agency for this indication as well as the treatment of anemia in cancer patients undergoing chemotherapy. Dr. Reddy's Laboratories launched darbepoetin alfa in India under the brand name ‘Cresp’ in August 2010. This is the world's first follow on biologic of darbepoetin alfa. Darbepoetin is produced by recombinant DNA technology in modified Chinese hamster ovary cells. It differs from endogenous erythropoietin (EPO) by containing two more N linked oligosaccharide chains. It is an erythropoiesis stimulating 165 amino acid protein. It is on the World Health Organization's List of Essential Medicines.

Use of darbepoetin alfa is contraindicated in patients with hypersensitivity to the drug, pre existing uncontrolled hypertension, and pure red cell aplasia.

Darbepoetin alfa has black box warnings in the United States for increased risk of death, myocardial infarction, stroke, venous thromboembolism, thrombosis of vascular access, and tumor progression or recurrence. To avoid side effects, it is recommended for patients with chronic kidney failure or cancer to use the lowest possible dose needed to avoid red blood cell (RBC) transfusions. In addition to those listed in the black box warning, use of darbepoetin alfa also increases the risk of cardiovascular problems, including cardiac arrest, arrhythmia, hypertension and congestive heart failure, and edema. Other reported adverse reactions include increased risk of seizure, hypotension, and chest pain.

Like EPO, darbepoetin alfa has the potential to be abused by athletes seeking a competitive advantage. Its use during the 2002 Winter Olympic Games to improve performance led to the disqualification of cross country skiers Larisa Lazutina of Russia, Olga Danilova of Russia and Johann Mühlegg of Spain from their final races.

Epogen and Aranesp had more than $6 billion in combined sales in 2006. Procrit sales were about $3.2 billion in 2006.