Darbepoetin administration to neonates undergoing cooling for encephalopathy: a safety and pharmacokinetic trial

作者:Baserga Mariana C*; Beachy Joanna C; Roberts Jessica K; Ward Robert M; DiGeronimo Robert J; Walsh William F; Ohls Robin K; Anderson Jennifer; Mayock Dennis E; Juul Sandra E; Christensen Robert D; Loertscher Ma***i C; Stockmann Chris; Sherwin Catherine M T; Spigarelli Michael G; Yoder Bradley A
来源:Pediatric Research, 2015, 78(3): 315-322.
DOI:10.1038/pr.2015.101

摘要

BACKGROUND: Despite therapeutic hypothermia, neonates with encephalopathy (NE) have high rates of death or disability. Darbepoetin alfa (Darbe) has comparable biological activity to erythropoietin, but has extended circulating half-life (t(1/2)). Our aim was to determine Darbe safety and pharmacokinetics as adjunctive therapy to hypothermia. STUDY DESIGN: Thirty infants (n = 10/arm) >= wk gestation undergoing therapeutic hypothermia for NE were randomized to receive placebo, Darbe low dose (2 mu g/kg), or high dose (10 mu g/kg) given intravenously within 12 h of birth (first dose/hypothermia condition) and at 7 d (second dose/normothermia condition). Adverse events were documented for 1 mo. Serum samples were obtained to characterize Darbe pharmacokinetics. RESULTS: Adverse events (hypotension, altered liver and renal function, seizures, and death) were similar to placebo and historical controls. Following the first Darbe dose at 2 and 10 mu g/kg, t(1/2), was 24 and 32h, and the area under the curve (AUC(ind)) was 26,555 and 180,886 h*mU/ml*, respectively. In addition, clearance was not significantly different between the doses (0.05 and 0.04 l/h). At 7 d, t(1/2) was 26 and 35 h, and AUC(inf) was 10,790 and 56,233 h*mU/ml*, respectively (*P < 0.01). CONCLUSION: Darbe combined with hypothermia has similar safety profile to placebo with pharmacokinetics sufficient for weekly administration.

  • 出版日期2015-9