RT Book, Section A1 NGUYEN, TIMOTHY A1 LAPSIA, VIJAY A1 KIM, SARA S. A2 Cohen, Henry SR Print(0) ID 1112259973 T1 Erythropoietin-Stimulating Agents T2 Casebook in Clinical Pharmacokinetics and Drug Dosing YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071628358 LK accesspharmacy.mhmedical.com/content.aspx?aid=1112259973 RD 2024/04/19 AB Erythropoietic stimulating agents (ESA) are recombinant and synthetic erythropoietin (EPO). They are structurally and biologically similar to endogenous EPO and are used in the management of various types of anemia. Drugs in this class are epoetin alfa, darbepoetin alfa, and peginesatide. ESAs work by stimulating the bone marrow to produce red blood cells. Epoetin alfa, sometimes referred to as recombinant human erythropoietin (rHuEPO), is an exogenous EPO manufactured by recombinant DNA technology, and it was approved by the Food and Drug Administration (FDA) in 1989. It contains a 165-amino acid sequence with three N-linked and one O-linked carbohydrate changes and has the same biological effects as endogenous EPO.1,2 It has a molecular weight of 30,400 daltons and is produced by mammalian cells.