Experience with Daily Self-Administered Subcutaneous Erythropoietin

Granolleras, C.; Branger, B.; Beau, M. C.; Deschodt, G; Alsabadani, B.; Shaldon, Stanley

doi:10.1159/000417890

Cited by 39 publications

(11 citation statements)

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“…2d) with an increas ing tendency, but without any differences be tween the two groups. In group I serum creati nine was unchanged throughout the study but [7] showed a dose reduction of 70%, changing from 3 times weekly i.v. r-HuEPO to daily s.c. r-HuEPO, maintaining the same hematopoietic effect.…”

Section: Discussionmentioning

confidence: 95%

“…injection, and the injection frequency can be reduced even to once a week. Otherwise daily adminis tration seems also to be an economic possibil ity [7,9], Once-weeklv doses have the incon venience of a bigger injected amount, which can be unpleasant for the patient. Daily ad ministration can cause a worse complicance in our experience and a larger waste of r-HuEPO because of the frequent prepara tions of doses.…”

Section: Discussionmentioning

confidence: 99%

“…In most reports the drug has been administered intravenously (i.v. ), but an increasing number of reports [5][6][7] have rec-ommended subcutaneous (s.c.) administra tion, as an equal hematologic response is achived even with a reduction in r-HuEPO dose of 30-70%. The ideal mode of adminis tration and dosage has yet to be identi fied.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Crossover Study of Intravenously and Subcutaneously Administered Recombinant Human Erythropoietin in Hemodialysis Patients

Steffensen¹,

Aunsholt²,

Ahlbom³

1992

Blood Purif

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A comparative crossover study of intravenously (i.v.) and subcutaneously (s.c.) administered recombinant human erythropoietin (r-HuEPO) was conducted in 20 patients with end-stage renal disease on maintenance hemodialysis. The patients were randomized into two groups. Group 1 received r-HuEPO i.v. thrice weekly and group II r-HuEPO s.c. twice weekly for 12 weeks, then the therapy was crossed over for another 12-week period. The initial dose was 50 U/kg/i.v. dose and 40 U/kg/s.c. dose. In all but 1 patient an adequate hematologic response was obtained. In group 1 the mean hemoglobin (Hb) level increased from 4.8 (Hbo) to 6.0 after 12 weeks (HbΠ) and further to 6.5 mmol/l after 24 weeks (Hb24) throughout the study (0.025 < p < 0.05). In group II it increased from 4.6 (Hb₀) to 7.1 (Hbι₂) to 6.9 mmol/l (Hb₂₄) (0.01 < p < 0.025). There was a significant difference between the two groups (p < 0.05). The rise in Hb in group II during the first 12 weeks of the study was achieved by only half the cumulative dose of r-HuEPO (11,820 U) per kilogram compared to the consumption in group I (24,575 U). In the last 12 weeks of the study the requirement of r-HuEPO to maintain Hb level was equal in the two groups. In group I serum erythropoietin (EPO) level increased slowly throughout the study. In group II an increment was followed by a decrease beyond prestudy level. This happened at an erythropoietic response with mean hematocrit (Hct) about 35%. In group I a mean Hct > 35% was never reached. This might indicate the existence of an EPO-Hct feedback mechanism. In conclusion, s.c. administration is significantly more effective than i.v. administration as induction therapy, requiring only half the dose of r-HuEPO. Also it can be administered twice weekly, and a start dose of 40 U/kg/dose is suggested aiming at a Hct not exceeding 35%.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Comparative Crossover Study of Intravenously and Subcutaneously Administered Recombinant Human Erythropoietin in Hemodialysis Patients

Steffensen¹,

Aunsholt²,

Ahlbom³

1992

Blood Purif

View full text Add to dashboard Cite

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“…Another important advantage of iv administration is a longer half-life (24 h vs 9 h) [158,159] . Daily sc EPO is more effective than administration 2-3 times weekly [160] , although administration less frequently than every 2 wk is also effective [161][162][163] . Discomfort at the injection site is minimal.…”

Section: Dosage Monitoring and Controlmentioning

confidence: 99%

Use of agents stimulating erythropoiesis in digestive diseases

López¹,

Sicilia²,

García³

2009

WJG

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Anemia is the most common complication of inflammatory bowel disease (IBD). Control and inadequate treatment leads to a worse quality of life and increased morbidity and hospitalization. Blood loss, and to a lesser extent, malabsorption of iron are the main causes of iron deficiency in IBD. There is also a variable component of anemia related to chronic inflammation. The anemia of chronic renal failure has been treated for many years with recombinant human erythropoietin (rHuEPO), which significantly improves quality of life and survival. Subsequently, rHuEPO has been used progressively in other conditions that occur with anemia of chronic processes such as cancer, rheumatoid arthritis or IBD, and anemia associated with the treatment of hepatitis C virus. Erythropoietic agents complete the range of available therapeutic options for treatment of anemia associated with IBD, which begins by treating the basis of the inflammatory disease, along with intravenous iron therapy as first choice. In cases of resistance to treatment with iron, combined therapy with erythropoietic agents aims to achieve near-normal levels of hemoglobin/hematocrit (11-12 g/dL). New formulations of intravenous iron (iron carboxymaltose) and the new generation of erythropoietic agents (darbepoetin and continuous erythropoietin receptor activator) will allow better dosing with the same efficacy and safety.

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“…This propo sal was universally followed as it was easy to give to the patient on hemodialysis at the end of each treatment. The possibility that this route and frequency were not perhaps optimal was rapidly suggested [2], Prelimi nary data on subcutaneous daily self-admin istered rHuEPO (SADSCEPO) were encour aging in regard to dose reduction compared to thrice weekly intravenous rHuEPO [3], …”

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confidence: 99%

Two Years Experience of Daily Self-Administered Subcutaneous Erythropoietin

Granolleras¹,

Branger²,

Deschodt³

et al. 1990

Blood Purif

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Recombinant human erythropoietin (EPO) has been used for 4 years in end-stage renal disease patients, administered intravenously 3 times a week. A study was undertaken to determine the optimal way of administration comparing 3 times weekly intravenous EPO to self-administered daily subcutaneous EPO (SADSCEPO). In a first group of 4 patients, we demonstrated that the change from 3 times weekly intravenous EPO to SADSCEPO permitted a dose reduction of 70%. In a second group of 20 patients who started the EPO therapy with the daily subcutaneous route at a median dose of 12 U/kg/day, the hematocrit increased from 20 to 30% in 4 months and remained over 30% in spite of a median dose reduction to 9 U/kg/day. The patients’ acceptance of SADSCEPO was good. The mechanism allowing such a dose reduction is unknown. However, the significant reduction in median dosage requirement with the subcutaneous route should allow a greater number of patients to be treated more cost-effectively.

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Experience with Daily Self-Administered Subcutaneous Erythropoietin

Cited by 39 publications

References 0 publications

Comparative Crossover Study of Intravenously and Subcutaneously Administered Recombinant Human Erythropoietin in Hemodialysis Patients

Comparative Crossover Study of Intravenously and Subcutaneously Administered Recombinant Human Erythropoietin in Hemodialysis Patients

Use of agents stimulating erythropoiesis in digestive diseases

Two Years Experience of Daily Self-Administered Subcutaneous Erythropoietin

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