Safety and Efficacy of Methoxy Polyethylene Glycol-epoetin Beta in Anemia Treatment in Patients on Hemodialysis: a Macedonian Experience.

INTRODUCTION: Anemia in patients with chronic kidney disease (CKD) is present in about 50% in pre-dialysis and over 90% of patients on hemodialysis. Erythropoiesis-stimulating agent (ESA) is a standard therapy for renal anemia, but management of anemia in CKD still remains a challenge from the treatment point of view. AIM: To evaluate safety and efficacy of methoxy polyethylene glycol-epoetin beta as continuous erythropoietin receptor activator (C.E.R.A.) in maintenance of haemoglobin (Hb) concentrations in patients with chronic renal anemia in the routine clinical practice. METHODS: National, multicenter, observational, prospective study in patients with CKD on hemodialysis for maintenance of Hb levels with once-monthly therapy with C.E.R.A. In 8 dialysis centers 184 adult patients were observed and followed up every month during one year. Total number of enrolled patients was 185 from whom 184 patients were observed and 147 patients were followed for 12 months as 37 dropped out from the study earlier. RESULTS: Overall mean dose of C.E.R.A. was 115.2 µg with average 4.99 dose modifications per patient. Among 184 patients observed, total number of 121 adverse events (AEs) were identified in 49 of the patients. The most of the AEs were of mild or moderate severity. A few serious AEs were assessed and reported as not related to the drug administration. Mean Hb levels during the study varied but were maintained stable in the range of 100-120 g/l. CONCLUSION: Safety and tolerability of C.E.R.A. was as expected as the frequency and type of AEs was similar to the known pattern from the studies done in other countries and relevant literature. Hb levels as the primary efficacy parameter of C.E.R.A. treatment were maintained stable within the target range during the study.

Professor Anastas Kocarev, First Macedonian Oncologist with Worldwide Reputation and Pioneer in Cancer Diagnostics and Treatment with Radium.

PhD. Anastas Kocarev (Kotzareff in French) is one of the most prominent Macedonian doctors and experts, prolific contributor to the cancer research in Switzerland and France in the first decades of the 20th century. He was born in Ohrid on May 5th, 1889. He graduated from the Faculty of Medicine in Geneva where he defended a doctorate in medicine in 1915. In 1916 he was elected Assistant Professor (Private Docent) at that Faculty. He was a prominent scientist and professor of experimental medicine at the Faculty of Medicine in Geneva and the Sorbonne University in Paris, with a wide reputation in Europe and the United States. PhD. A. Kocarev is one of the pioneers of oncology and radiology in the world, a forerunner of modern nuclear medicine and positron emission tomography. He was a close associate of Nobel laureate in chemistry and physics Maria Sklodovska-Curie and at her invitation moved to Paris in 1925 to continue the research on the diagnosis and treatment of cancer using radium. He was fully devoted to science and published numerous scientific papers and books with high citations and dissemination in many medical libraries in Europe and beyond. In addition to his professional teaching and scientific work as a top oncologist-radiologist, he was a great patriot with advanced political ideas. He founded the Academic Society "Macedonia" in Geneva, in 1915, and united it with other Macedonian political associations from Zurich and Lausanne, in 1918, into a joint "Alliance of Macedonian Societies for Independent Macedonia", with commitments, activities and initiatives to the Society of Nations, based in Geneva, Switzerland, for the proper resolution of the Macedonian national issue by creating a united and independent state "Macedonia" or the formation of a "Balkan Federation". He died suddenly in Paris on March 29, 1931.