Aranesp

Aranesp is the brand name for darbepoetin alfa, a synthetic erythropoiesis-stimulating agent (ESA) used to treat anemia in certain chronic conditions. It is a recombinant glycoprotein that mimics endogenous erythropoietin but has enhanced sialylation, giving it a longer half-life and allowing less frequent dosing than recombinant human erythropoietin.

Indications: Aranesp is approved in many countries for the treatment of anemia associated with chronic kidney disease (both with and without dialysis) and for anemia due to cancer chemotherapy. It is used to reduce the need for red blood cell transfusions. Dosing and duration depend on the underlying condition, patient response, and hemoglobin levels.

Mechanism of action: It binds erythropoietin receptors on erythroid progenitor cells in the bone marrow, stimulating the production of red blood cells and thereby increasing hemoglobin and hematocrit.

Administration and dosing: Aranesp is given by subcutaneous or intravenous injection. Dosing frequency can be weekly, every two weeks, or monthly in CKD patients, and weekly or per chemotherapy cycle in oncology settings. Dosage is titrated to reach and maintain a target hemoglobin within approved limits, while avoiding rapid rises of hemoglobin.

Safety: Use is associated with risks common to ESAs, including hypertension, thromboembolic events, cardiovascular events, and, in cancer patients, potential effects on tumor progression or survival. Rare cases of neutralizing antibodies causing pure red cell aplasia have been reported. Regulatory guidance emphasizes using the lowest effective dose and avoiding Hb levels above 11 g/dL where possible. Contraindications include hypersensitivity to darbepoetin alfa or other components of the formulation and uncontrolled hypertension.