Erythropoietin mimetic peptides and erythropoietin fusion proteins for treating anemia of chronic kidney disease

Purpose of review First generation erythropoiesis stimulating agents (ESAs) have short duration of action which requires administration once weekly or greater. Second generation ESAs were developed which have longer duration of action and can be administered one to two times monthly. Erythropoietin (EPO) mimetic peptides (EMPs) activate the EPO receptor but have no structural analogy to EPO, offering the potential for lower cost as they are not biologic drugs. The first approved EMP, peginesatide, was withdrawn from the market within a year of its approval because of fatal anaphylactic reactions. In this review, we summarize recent progress regarding the development of newer, possibly less toxic, EMPs. We also summarize the development of EPO fusion proteins which fuse EPO with a portion of an immunoglobulin molecule or another EPO molecule, achieving a longer duration of action and less frequent dosing. Recent findings AGEM400(hydroxyethyl starch) and pegolsihematide are EMPs in phase II clinical trials. Three EPO fusion proteins are under development, two in phase I and one in phase II. Summary The future success of EMPs is limited by the prior experience with peginesatide and EPO fusion proteins do not offer cost savings or longer duration of action than currently available ESAs.
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

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Conclusions: The developed web DB system contributed to improve the health condition of the health program participants by providing necessary information to the health professionals at the right time. This case report could be a reference for other researcher to develop web databases for their own context, especially in developing countries. PMID: 30788180 [PubMed]
Source: Healthcare Informatics Research - Category: Information Technology Tags: Healthc Inform Res Source Type: research
Pediatric hypertension (HTN) is commonly due to secondary causes such as renal parenchymal disease or renal artery stenosis (RAS). But, the impact of accessory renal arteries on the renin-angiotensin-aldosterone feedback system and potential for causing HTN is not known. First proposed by Glodny et al in 2001, parenchyma supplied by ‘accessory’ vessels may have lower blood pressure (BP) than the dominant renal parenchyma triggering renin secretion. The purpose of this study is to evaluate the safety and efficacy of accessory renal artery embolization (ARAE) in children presenting with suspected renal artery HTN.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 5: You ’ve Got To Be Kid-ing Me (Pediatric IR) Source Type: research
TIPS creation is typically reserved for patients with refractory ascites or variceal hemorrhage. While TIPS have also been created prior to planned abdominal operation to decrease morbidity related to portal hypertension, there is little in the literature supporting its effectiveness in that indication. The goal of this study was to determine if preoperative TIPS creation allows successful abdominal operation and improves outcomes.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 18: Tips For TIPS Source Type: research
To evaluate the feasibility of 2D Parametric Parenchymal Blood Flow (2D-PPBF) to quantify perfusion changes of the lung parenchyma following balloon pulmonary angioplasty (BPA) for treatment of chronic thromboembolic pulmonary hypertension.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 16: Clot Busters (DVT PE) Source Type: research
In this study, we investigate the accuracy of WHVP as a surrogate for DPP.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 8: Hepatic Traffic (Portal Hypertension and Flow) Source Type: research
The Fontan procedure enables prolonged survival of patients with single-ventricle physiology. As these patients progress to adulthood, Fontan-associated liver disease (FALD) is becoming more prominent. Liver biopsy remains the standard for diagnosis of FALD. Transabdominal liver biopsy carries risk for bleeding in these patients with congestive hepatopathy and limited cardiac reserve. Transjugular liver biopsy (TJLB) may be difficult due to complex Fontan venous anatomy. In addition, as FALD may have heterogenous involvement of the liver, tissue samples adjacent to the hepatic veins where congestion can be pronounced may n...
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 8: Hepatic Traffic (Portal Hypertension and Flow) Source Type: research
Portomesenteric venous thrombosis (PMVT) can be potentially life-threatening in both the acute and chronic setting due to complications of mesenteric ischemia and infarction, portal hypertension and gastrointestinal hemorrhage. Bariatric patients are at an increased risk of thromboembolic disease and postoperative PMVT has been described following both open bariatric surgery and laparoscopic techniques. While therapeutic anticoagulation is recommended in stable patients with acute PMVT, symptomatic thrombosis with concern for bowel ischemia requires more aggressive therapy such as TIPS, endovascular thrombolysis and thrombectomy.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 28: Cirrhosis Central Source Type: research
Hepatic parenchyma normally derives the majority of its blood supply from the portal venous system. However, in patients with cirrhosis and portal hypertension, there is expected to be less portal supply to the parenchyma and a greater reliance on the hepatic arterial system. With bland transarterial embolization (TAE), deprivation of arterial blood supply may have a more detrimental effects on overall hepatic perfusion, function, and survival in this population. Given the high correlation of splenomegaly with portal hypertension, the purpose of this study was to analyze whether the degree of splenomegaly impacts survival ...
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 26: Something New, Something Blue (Transplant and Splenic Interventions) Source Type: research
Authors: Del Vecchio L, Locatelli F Abstract Introduction Erythropoiesis stimulating agents (ESA) are effective drugs, which have been used for decades in patients with chronic kidney disease (CKD) with few side effects. More recently, concern has been raised around their safety, from higher cardiovascular and thrombosis risk to cancer progression and increased mortality. Areas covered We made a literature search on PubMed looking for adverse effects of ESA in CKD patients. The topics covered are cardiovascular adverse events, thrombosis, increased mortality, hypertension, cancer progression, diabetic retinopathy, ...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research
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Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news
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