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"Background: treatment of erythropoietin (EPO) is essential in chronic kidney disease (CKD) patients to maintain optimal hemoglobin (Hb) level. Renogen is a biosimilar epoetin-α, and Eprex is the originator epoetin-α. This study aimed to compare the efficacy and tolerance of Renogen with Eprex in CKD anemia.Methods: Renogen and Eprex were compared in a randomized (2:1), open-label study for 8 weeks, proceeded by 4 weeks adjustment (maintenance) phase, in anemic CKD patients undergoing HD in Cipto Mangunkusumo General Hospital, Jakarta, from June 2017 to October 2018.Results: a total of 45 patients (31 received biosimilar EPO and 14 received originator EPO) were included in the study. At baseline, mean (SD) Hb levels were 10,9 (0,74) g/dL and 10,9 (0,61) g/dL in biosimilar and originator EPO groups, respectively. At end of study (8 weeks), mean (SD) Hb levels were 10,5 (1,28) g/dL and 11,0 (1,13) g/dL in biosimilar EPO and originator EPO groups, respectively. The proportion of patients with Hb levels maintained within the target range (>10 g/dL) during 8 weeks randomization phase were 58,1% and 71,4% in biosimilar EPO and originator EPO, respectively (p=0,60; NS). There were no significant difference in epoetin dose between the 2 groups, and there was no drug-related adverse event in either group.Conclusion: Hb level at >10 g/dL could be maintained for 8 weeks of treatment with both originator and biosimilar EPO (more consistent with originator EPO and more fluctuations with biosimilar EPO), with similar epoetin dose and no drug-related adverse event."

"ABSTRACTCardiovascular disease (CVD) remain a leading cause of death globally. The concept of acute myocardial infarction in young adults was uncommon. Atherosclerosis is the leading cause of CVD, including myocardial infarction, stroke, heart failure and peripheral artery disease. This condition is initiated early in childhood and progressive in nature. CVD risk factors includes hypertension, dyslipidemia and obesity play a role in the development of atherosclerosis and components in insulin resistance syndrome.One of many risk factors for insulin resistance in healthy individuals is a first-degree relative (FDR) of Type 2 Diabetes Mellitus (T2DM) patients. This group shows a higher risk of insulin resistance and pancreatic beta cells disruption even in adolescence, although they often remains asymptomatic. Clinical manifestations of metabolic disorders and atherosclerosis will appear earlier in the FDR T2DM group who have sedentary lifestyles and obesity, when compared to the non-FDR group. Several studies have attempted to detect metabolic disorders and subclinical atherosclerosis that might occur; therefore an early prevention can be carried out in these high-risk groups. Unfortunately, factors that affect the onset and the severity of the prospective clinical manifestations from the previous studies remained inconclusive."