Darbepoetin alfa

Darbepoetin alfa (rINN) is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anaemia, commonly associated with chronic renal failure and cancer chemotherapy. Darbepoetin is marketed by Amgen under the trade name Aranesp.

It was approved in September 2001 by the Food and Drug Administration for treatment of patients with chronic renal failure by intravenous or subcutaneous injection.

It is produced by recombinant DNA technology in modified Chinese hamster ovary cells. It differs from endogenous erythropoietin by containing two more N-linked oligosaccharide chains. It is an erythropoiesis stimulating 165-amino acid protein.

Like EPO its use increases the risk of cardiovascular problems, including cardiac arrest, seizures, arrhythmia or strokes, hypertension and hypertensive encephalopathy, congestive heart failure, vascular thrombosis or ischaemia, myocardial infarction and oedema. Pre-existing hypertension contra-indicates the use of darbepoetin as does existing a hematologic disease. Adverse reactions can include hypotension, fever, chest pains, nausea and myalgia.

Also like EPO it has the potential to be abused by athletes seeking an advantage. Its use during the 2002 Winter Olympic Games to improve performance led to the disqualification of cross-country skiers Larisa Lazutina and Olga Danilova of Russia and Johann Mühlegg of Spain from their final races.

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