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Clin Kidney J. Of the 29 patients transfused during the post-switch period, 20 had a dose ratio at switch <1, and 9 had a dose ratio at switch 1 (odds ratio 2.39, 95% CI 1.05, 5.44; P=0.038). https://doi.org/10.1007/s12325-013-0063-y, DOI: https://doi.org/10.1007/s12325-013-0063-y. Examine each prefilled syringe for the expiration date. There were 16 transfusions and 34 units transfused in the pre-switch period, versus 48 transfusions and 95 units transfused post-switch. Mircera solution for injection in pre-filled syringe The primary outcome (DCR) for each patient was calculated as the mean weekly dose of PEG-Epo during the post-switch EP divided by the mean weekly dose of DA during the pre-switch EP. Lancet. in the treatment of anemia due to cancer chemotherapy. Kidney Int. 2002;162:14011408. Learn how to combine multiple dosing options for precise titration and individualize anemia management.1. Secondary outcomes included Hb concentrations and ESA use during the study period, and the incidence of red blood cell (RBC) transfusions. 1986;327:30710. randomized patients to darbepoetin or epoetin beta once weekly after the patients had been treated with epoetin beta three times weekly. 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. MIRCERA is an erythropoiesis-stimulating agent (ESA) indicated for the treatment of anemia associated with chronic kidney disease (CKD) in: MIRCERA is not indicated and is not recommended for use: MIRCERA has not been shown to improve quality of life, fatigue, or patient well-being. In pediatric patients, Mircera is administered by intravenous injection only (2.2). Unable to load your collection due to an error, Unable to load your delegates due to an error. Data quality and completeness were aided by automatic edit checks built into the database software. Macdougall IC, Obrador GT, El Nahas M. How important is transfusion avoidance in 2013? Figure4 also displays the mean monthly Hb for those included in the DCR analysis over the study period. 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. 2010;25:400917. If Hb exceeds a level needed to avoid RBC transfusions, withhold dose until Hb approaches a level where RBC transfusions may be required and reinitiate at a dose 40% below the previous dose. 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. 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. Therapeutic effects . Table 1 Mircera Starting Doses for Adult Patients Currently Receiving an ESA, Table 2 Mircera Starting Doses for Pediatric Patients Currently Receiving an ESA. For adverse event reports, please contact us at safety@viforpharma.com,mircera@viforpharma.com or at 1-800-576-8295. 2001;38:80312. Please enable it to take advantage of the complete set of features! Karaboyas A, Morgenstern H, Fleischer NL, Vanholder RC, Dhalwani NN, Schaeffner E, Schaubel DE, Akizawa T, James G, Sinsakul MV, Pisoni RL, Robinson BM. endobj Last updated on Jul 26, 2022. ESAs resulted in decreased locoregional control/progression-free survival and/or overall survival. 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. The relationship between the DA and PEG-Epo doses during the evaluation periods was explored through linear and quadratic regression. 2002;162:14018. Evaluate the iron status in all patients before and during treatment. doi: 10.1002/14651858.CD010590.pub2. Most frequent adverse reactions (5%) in adult patients with CKD treated with MIRCERA. MIRCERA comes in pre-filled syringes with laminated plunger stopper and tip cap with one needle 27G1/2. Methoxy polyethylene glycol-epoetin (Mircera ) will be increased and decreased in 1-step or 2-step increments, based on scale above. Mircera is not the same as epoetin alfa (Procrit, Epogen). This medicine is not used to treat anemia caused by cancer medicines. Nephrol Dial Transplant. W\iA* Would you like email updates of new search results? MIRCERA Dosage & Rx Info | Uses, Side Effects - MPR 2012;59:444451. reaction occurs. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. This was particularly evident in patients whose pre-switch EP weekly DA dose was higher than 100g. 4! A decade in the anaemia market - 10 products seen top . Anemia response to Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) versus Epoetin Alfa (Eprex) in patients with chronic Kidney disease on Hemodialysis Published: September 05, 2017 42/47 is common in patients with a GFR below 30 ml/min/1.73m2 and contributes to many of the speciic symptoms of CKD. In the first month after switch, these proportions were 10.2%, 48.5% and 37.4%, respectively. Administer Mircera as an intravenous injection at the dose (in micrograms) based on the total weekly ESA dose at the time of conversion (see Table 2). The primary finding of the study is that the DCR of PEG-Epo to DA was 1.17 (95% CI 1.05, 1.29). Nick Manamley, MSc, is an employee of Amgen with Amgen stock ownership. Goodkin DA, Zhao J, Cases A, Nangaku M, Karaboyas A. before initiating MIRCERA. 2001;38:803812. When adjusting therapy, consider hemoglobin rate of rise, rate of decline, ESA responsiveness, and hemoglobin variability. See Instructions for Use for complete instructions on the preparation and administration of Mircera. RETACRIT Dosage and Administration (epoetin alfa-epbx) 5) shows that most transfusions occurred in the first 4months post-switch. 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. 1MIRCERA [prescribing information]. Methoxy polyethylene glycol-epoetin beta injection causes the . Mircera Dosage Guide - Drugs.com doi: 10.1093/ndt/17.suppl_5.66. See this image and copyright information in PMC. PEG-Epo methoxy polyethylene glycol-epoetin beta. Mircera is packaged as single-dose prefilled syringes. The majority of patients with CKD will require supplemental iron during the course of ESA therapy. ?Ij{JVv:oC*#]}V#$M_T.zC>~] L%lq[Tn`QbWB./@ClVgrk)U-j#(0(D Am J Kidney Dis. <>/Metadata 444 0 R/ViewerPreferences 445 0 R>> eCollection 2020 May-Jun. 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. *Data from a multicenter, randomized, open-label study comparing epoetin, given 1, 2, or 3 times weekly IV or SC, with ARANESP , at a reduced dose frequency, in dialysis patients (N = 522).Dose adjustments were made as necessary and per study protocol to maintain individual patients' Hb within a target range of -1.0 to +1.5 g/dL of their baseline Hb and between 9 g/dL and 13 g/dL for up . 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. The conversion rate was 354:1 in patients requiring high (>200 IU/kg/week) doses of epoetin and 291:1 in patients requiring low doses. If typical causes of lack or loss of hemoglobin response are excluded, evaluate for PRCA. A primary growth factor for erythroid development, erythropoietin is produced in the kidney and released into the bloodstream in response to hypoxia. Asterisk Not all transfusions had an associated hemoglobin concentration in the 14-day period before transfusion. ^D[5j@%e PubMed 2019 Jul 5;13(3):425-433. doi: 10.1093/ckj/sfz065. Product Information and Dosing | Mircera Choi, P., Farouk, M., Manamley, N. et al. Before New anemia therapies: translating novel strategies from bench to bedside. Conversion - Epoetin alfa (Procrit) to Darbepoetin | GrepMed The mean (95% CI) monthly Hb immediately prior to switch, in Month 1 post-switch, and in Month 7 post-switch was 11.5g/dL (11.3, 11.7), 11.7g/dL (11.5, 11.9), and 11.4g/dL (11.3, 11.6), respectively. Evaluate the iron status in all patients before and during treatment. Publication management support was provided by Caterina Hatzifoti, PhD, of Amgen Europe GmbH. Conversion from Epoetin alfa or Darbepoetin alfa to Mircera in Pediatric Patients with CKD Treated with Hemodialysis Administer Mircera intravenously once every 4 weeks to pediatric patients (ages 5 to 17 years) whose hemoglobin level has been stabilized by treatment with an ESA. Dialysis centers were expected to adhere to European Best Practice Guidelines for iron repletion [9]. New anemia therapies: translating novel strategies from bench to bedside. Methoxy polyethylene glycol-epoetin beta, sold under the brand name Mircera, is a long-acting erythropoietin receptor activator (CERA) used for the treatment of anaemia associated with chronic kidney disease. Methoxy polyethylene glycol-epoetin beta - Wikipedia In an additional analysis performed to assess the sensitivity of this result to the effects of transfusion by excluding those patients who received an RBC transfusion within 90days prior to or during either evaluation period, the DCR was 1.21 (95% CI 1.09, 1.35). Do not use any prefilled syringes exhibiting particulate matter or a coloration other than colorless to slightly yellowish. Disposition of patients. Summary of the last hemoglobin concentrations recorded within 14days prior to red blood cell transfusions pre- and post-switch. history of serious or severe allergic reactions to MIRCERA (e.g., anaphylactic reactions, angioedema, bronchospasm, pruritus, skin rash, and urticaria). Show detailed description Study Design Go to stream Administer Mircera either intravenously or subcutaneously in adult patients and only intravenously in pediatric patients. 1:1 reference line indicates equal PEG-Epo and darbepoetin alfa doses. We comply with the HONcode standard for trustworthy health information. \ab/`IR 4%jI ^w7qQNA Tq Wz.oVfCVBT{h*>\\3u#P@"wW7|pIMB7 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. 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. Adv Ther 30, 10071017 (2013). Dr. Peter Choi is the guarantor for this article, and takes responsibility for the integrity of the work as a whole. Initial Treatment: 0.6 mcg/kg body weight administered once every two weeks (2.2). OZZ Shortened red blood cell age in patients with end-stage renal disease who were receiving haemodialysis: a cross-sectional study. The remaining enrolment was at four sites divided between three other countries. The distribution of Hb values reported within the 14days prior to transfusion was described; if multiple Hb values were recorded, the value closest to the transfusion date was utilized. An additional analysis was performed to explore the effect of transfusions on the DCR, by exclusion of patients with a transfusion within 90days prior to or during either EP from the analysis. Part of Springer Nature. 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. Avoid frequent dose adjustments. 600 Units/kg subcutaneously in 4 doses administered 21, 14, and 7 days before surgery and on the day of surgery. 2012 Jun;27(6):2303-11. doi: 10.1093/ndt/gfr677. Please know that the sponsors of this site are not responsible for content on the site you are about to enter. Pharmacotherapy Update - Automatic Therapeutic Interchange Program Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Once Every Two Weeks (mcg/every two weeks). . What is/was your patient's PRETREATMENT hemoglobin level (g/dL) [prior to use of epoetin (Aranesp, Epogen, Mircera, Procrit, Retacrit)]? 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 This medicine is not for treating anemia caused by cancer chemotherapy. What is the practical conversion dose when changing from epoetin alfa Pure red cell aplasia (PRCA) that begins after treatment with Mircera or other erythropoietin protein drugs. Anemia: an early complication of chronic renal insufficiency. official website and that any information you provide is encrypted Excluding patients receiving a transfusion within 90 days of or during either EP, the DCR was 1.21 (95% CI 1.09, 1.35). 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 patients treated with Aranesp or EPOGEN. Methoxy polyethylene glycol-epoetin beta | Drugs | BNF | NICE Mean Hb was 11.5g/dL in the pre-switch EP and 11.4g/dL in the post-switch EP. The number of transfusions and units transfused increased approximately threefold from the pre-switch to the post-switch period. Please click the OK button below to continue. Mircera would also have competed with Aranesp and with Procrit . as a substitute for red blood cell transfusions in patients who require immediate correction of anemia. In controlled clinical trials of patients with CKD comparing higher hemoglobin targets (13 to 14 g/dL) to lower targets (9 to 11.3 g/dL), ESAs increased the risk of death, myocardial infarction, stroke, congestive heart failure, thrombosis of hemodialysis vascular access, and other thromboembolic events in the higher target groups. In conclusion, this study has shown that in a cohort of European hemodialysis patients who converted from DA to PEG-Epo (and who completed 67months treatment with PEG-Epo post-conversion), there was an approximately 20% increase in the g dose required to achieve a comparable Hb profile. For patients who do not respond adequately over a 12-week escalation period, increasing the MIRCERA, Evaluate other causes of anemia. 2014 Dec 8;2014(12):CD010590. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Use caution in patients with coexistent cardiovascular disease and stroke. This study and the article processing charges were funded by Amgen Europe GmbH, Zug, Switzerland. A BlandAltman analysis [10] was also performed to assess the agreement between ESA doses in the evaluation periods. A motion conversion mechanism 123 includes a yoke 153 and a rotatable member 149, which causes the yoke 152, . Section III: Treatment of renal anaemia. Epub 2022 Apr 22. A rate of hemoglobin rise of > 1 g/dL over 2 weeks may contribute to these 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). 2009 Nov-Dec;15(9):741-50. doi: 10.18553/jmcp.2009.15.9.741. 2022;53(5):333-342. doi: 10.1159/000523947. adult patients on dialysis and adult patients not on dialysis. St. Gallen, Switzerland: Vifor (International) Inc.; June 2018. 1985;28:15. Palmer SC, Saglimbene V, Mavridis D, Salanti G, Craig JC, Tonelli M, Wiebe N, Strippoli GF. Mean Hb was 11.5 g/dL in the pre-switch EP and 11.4 g/dL in the post-switch EP. Empirical methods to calculate an erythropoiesis-stimulating agent dose conversion ratio in nondialyzed patients with chronic kidney disease. Red blood cell transfusions pre- and post-switch were quantified. Studies of erythropoietin therapy in patients with chronic anemia of cancer as well as CIA document response rates ranging from ~60% to 85%. 2020 Sep 29;21(1):418. doi: 10.1186/s12882-020-02078-z. 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). ARANESP (darbepoetine alfa) 1 injection/sem. 3. HQ-MIR-1900027 Site last modified: January 2023. Mircera works like the human protein called erythropoietin to help your body make more RBCs. Mircera (Methoxy Polyethylene glycol-epoetin beta): Uses - RxList Not all pack sizes may be marketed. Optimizing the use of erythropoietic agentspharmacokinetic and pharmacodynamic considerations. Google Scholar. PDF Anemia response to Methoxy Polyethylene Glycol-Epoetin Beta (Mircera -, Eschbach JW, Adamson JW. Am J Kidney Dis. Peter Choi, MB BChir, PhD, FRCP (UK), has received lecturing and consulting fees from Amgen, and has participated in advisory boards for Amgen. 2023Vifor (International) Inc. All rights reserved. If the hemoglobin rises rapidly (e.g., more than 1 g/dL in any 2-week period), reduce the dose of MIRCERA. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Mircera | European Medicines Agency Eligible patients had received hemodialysis for 12months and DA for 7months. endobj For more information, please see the full Prescribing Information, including Boxed WARNING, and Medication Guide(English, Espaol) for MIRCERA. Department of Nephrology, John Hunter Hospital, Lookout Road, New Lambton Heights, NSW, 2305, Australia, Amgen (Europe) GmbH, Dammstrasse 23, P.O. Unauthorized use of these marks is strictly prohibited. Available for Android and iOS devices. 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. The enrolling dialysis centers were situated in France, Germany, Spain and the UK, and each was expected to enroll a minimum of 20 patients into the study. Disposition of patients. Anemia Associated with Chronic Renal Failure, Methoxy polyethylene glycol-epoetin beta 30ug in 0.3mL, Drug class: recombinant human erythropoietins. 2023Vifor (International) Inc. All rights reserved. Regression analysis indicated a non-linear relationship between pre- and post-switch ESA doses; DCR decreased with increasing pre-switch DA dose. Use the lowest Mircera dose sufficient to reduce the need for red blood cell (RBC) transfusions. 6). Action Stimulates erythropoesis (production of red blood cells). If you are a healthcare professional outside of the US, please, visit www.mircera.global, The rate of hemoglobin decline indicates the likelihood of requiring a RBC transfusion, and, Reducing the risk of alloimmunization and/or other RBC transfusion-related risks is a goal, For adverse event reports, please contact us at, You may also report negative side effects of prescription drugs to, the Food and Drug Administration (FDA). Serious allergic reactions, including anaphylactic reactions, angioedema, bronchospasm, skin rash, and urticaria may occur with Aranesp or EPOGEN. 1. MIRCERA (methoxy polyethylene glycol-epoetin beta) is the first erythropoiesis-stimulating agent (ESA) approved by FDA for once-monthly administration. The geometric mean DCR was 1.17 (95% CI 1.05, 1.29). Conversion from Epoetin alfa or Darbepoetin alfa to Mircera in Adult Patients with CKD. Methoxy Polyethylene Glycol-Epoetin Beta (Injection Route) Methoxy polyethylene demonstrated that the dose efficiency after SC and IV ad- glycol-epoetin b (PEG-epoetin b; Mircera; F. Hoffmann- ministration was . Slider with three articles shown per slide. Macdougall IC. BlandAltman analysis of agreement between pre- and post-switch erythropoiesis-stimulating agent dose (n=205). risks. Mircera contains no preservatives. Recombinant human erythropoietins: very rare risk of severe cutaneous 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. RBC transfusions were reported in terms of number of transfusions and number of units transfused, using descriptive statistics. Each dosage strength of MIRCERA is designated by a unique syringe plunger color. Careers. Dose Conversion Ratio in Hemodialysis Patients Switched from Darbepoetin Alfa to PEG-Epoetin Beta: AFFIRM Study. _____ (if . 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. MIRCERA is indicated for the treatment of anemia associated with CKD in adult patients on dialysis and adult patients not on dialysis. 4 x previous weekly epoetin alfa dose (Units)/125, e.g., 4 x 1500 Units of epoetin alfa per week/125 = 48 mcg of Mircera once every 4 weeks, 4 x previous weekly darbepoetin alfa dose (mcg)/0.55, e.g., 4 x 20 mcg of darbepoetin alfa per week/0.55 = 145.5 mcg of Mircera once every 4 weeks. For administration using the prefilled syringe, the plunger must be fully depressed during injection in order for the needle guard to activate. Clipboard, Search History, and several other advanced features are temporarily unavailable. ferrous sulfate, Aranesp, Procrit, Retacrit. Mircera: Basics, Side Effects & Reviews - GoodRx This compares with a 35% decline in Epogen sales during the same period to $1.13bn, as competition from Mircera and biosimilars, like by Sandoz' Binocrit, reach the markets. Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. 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. 1985;28:15. PDF Anmie chez l'insuffisant rnal : comment utiliser les agents stimulant Dissertation Les Fausses Confidences Stratagme, Les Fromagers De Thirache Horaires, Archange Gabriel Pouvoir, Adeline Franois Mari, Rdiger Un Rapport Sur Un lve En Difficult . 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 No trial has identified a hemoglobin target level, ESA dose, or dosing strategy that does not increase these risks. Nephrol Dial Transplant. Conclusion: Intravenous C.E.R.A. Anemia of end-stage renal disease (ESRD). Mircera with 1-step decrease as soon as Hgb is < 11.8 g/dL and last dose was administered 2 weeks ago or more. All patients who fulfilled pre-specified criteria for completeness of Hb and dosing data were included in the DCR analysis: i.e., those who had received DA or PEG-Epo as the only ESA in the 1month prior to and during the pre- or post-switch EPs, respectively, and who had dosing information and at least 1 Hb value in each of the evaluation periods. WARNING: ESAs INCREASE THE RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, THROMBOSIS OF VASCULAR ACCESS and TUMOR PROGRESSION OR RECURRENCE CHRONIC KIDNEY DISEASE: Please see full Prescribing Information including Boxed WARNING, and Medication Guide(English, Espaol) for MIRCERA (methoxy polyethylene glycol-epoetin beta) Injection, for Intravenous or Subcutaneous Use. [citation needed] 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. Mircera at Best Price in India - IndiaMART MIRCERA is a registered trademark of F. Hoffmann-La Roche Ltd. All Vifor Pharma Groups intellectual rights, including copyright, are, The information provided in this site is intended only for healthcare. Aztec notes.docx - The kidneys are the primary organ of the . Analysis of relationship between pre- and post-switch erythropoiesis-stimulating agent dose. 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. Individualize dosing and use the lowest dose of MIRCERA. Tables2 and 3 also summarize the proportion of patients in different Hb categories by study month. Pure red cell aplasia (PRCA) that begins after treatment with MIRCERA, History of serious or severe allergic reactions to MIRCERA. 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. Eligible patients were randomized, either to continue on the previous regimen of Epoetin, or to receive Darbepoetin alfa or continuous erythropoietin receptor activator (C.E.R.A) for a total period of 40 weeks. National Library of Medicine Mircera Injection (Methoxy Polyethylene Glycol-Epoetin Beta ) 6,610/ Piece Get Latest Price. The odds ratio for receiving a transfusion was twice as high in patients switched at a dose ratio less than 1 when compared to those switched at 1:1 or higher. In contrast, in the STRIATA study where stable hemodialysis patients receiving IV DA were randomized to Q2W PEG-Epo (outside current label guidance) or to continue on DA QW or Q2W, median PEG-Epo doses were described as stable across the 52-week post-switch period, although mean dose data were not reported [12]. Composition: Methoxy Polyethylene Glycol-Epoetin Beta.