MIRCERA
Methoxy polyethylene glycol-epoetin beta
Treatment of anemia associated with chronic kidney disease
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.[3] It is the first approved, chemically modified erythropoiesis-stimulating agent (ESA).[citation needed]
It is on the World Health Organization's List of Essential Medicines.[5] It was approved for medical use in the European Union, [4] Switzerland,[citation needed] and the United States in 2007.[3]
Methoxy polyethylene glycol-epoetin beta is made from erythropoietin by chemically linking the N-terminal amino group or the ε-amino group of any lysine present in the protein with methoxy polyethylene glycol butanoic acid.[citation needed] The average molecular weight is approximately 60 kDa.[6] The drug stimulates erythropoiesis by interacting with the erythropoietin receptor on progenitor cells in the bone marrow.[6] It has a reduced receptor binding activity compared to other ESAs and but retains in vivo activity due to an extended serum half-life.[medical citation needed] It has an in vivo half-life of around 135 hours (5.6 days) as compared to darbepoetin alfa which has a half life of around 21 to 70 hours, the half life of which is three times that of the naturally occurring erthropoietin in the body.[medical citation needed]