Subcutaneous Compared with Intravenous Epoetin in Patients Receiving Hemodialysis

Kaufman, James S.; Reda, Domenic J.; Fye, Carol L.; Goldfarb, David S.; Henderson, William G.; Kleinman, Joel C.; Vaamonde, Carlos A.

doi:10.1056/nejm199808273390902

Cited by 264 publications

(85 citation statements)

References 23 publications

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“…In Europe and the USA, many clinical studies comparing intravenous and subcutaneous injections revealed that subcutaneous injection of rHuEPO is more advantageous than intravenous injection in terms of the improvement in anemia and its long-lasting effect, as well as costeffectiveness [64][65][66][67][68][69][70][71][72][73][74][75][76][77]. In the conventional European and US guidelines on therapy for renal anemia [78,79], subcutaneous injection was also recommended for HD patients.…”

Section: (2)target Hb Levels To Be Maintained In Pd Patientsmentioning

confidence: 99%

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Yamamoto¹,

et al. 2017

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Section: (2)target Hb Levels To Be Maintained In Pd Patientsmentioning

confidence: 99%

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Yamamoto¹,

et al. 2017

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“…28 Therapy with erythropoietin is useful in diseases complicated by anemia with low or inadequate erythropoietin levels, such as end-stage renal disease, multiple myeloma, rheumatoid arthritis, and prematurity. 4,5,[7][8][9][10] Therapeutic administration of erythropoietin can improve hemoglobin levels and anemic symptoms in many patients with these disorders. Our results suggest that patients with cirrhosis who have inappropriately low serum erythropoietin levels may also benefit from treatment with exogenous erythropoietin.…”

Section: Discussionmentioning

confidence: 99%

Erythropoietin response to post–liver transplantation anemia

et al. 2000

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Anemia frequently accompanies end-stage liver disease. Erythropoietin has recently been shown to be of benefit in a number of diseases complicated by anemia. We studied erythropoietin levels before and after orthotopic liver transplantation (OLT) and correlated these with the degree of anemia. Twenty-seven patients with end-stage cirrhosis who underwent OLT had preoperative and weekly postoperative serum erythropoietin levels determined by a highly sensitive radioimmunoassay. The relation of erythropoietin level to the values for hematocrit, serum creatinine, and cyclosporine and other biochemical test results was evaluated. Before transplantation, 23 patients were anemic; erythropoietin levels were appropriately elevated (72.7 ؎ 37 mU/mL; normal, 10 to 15 mU/mL) for the degree of anemia (hematocrit, 33.1% ؎ 1%) in 16 patients (70%). A blunted erythropoietin response to anemia was found in 7 of the anemic patients with cirrhosis (30%). After OLT, the hematocrit decreased to 29.5% ؎ 0.6% at 4 weeks, with a reciprocal increase in serum erythropoietin levels to 36 ؎ 5 mU/mL. Erythropoietin response appeared appropriate to the degree of anemia in 82% of the liver transplant recipients and blunted in 18%. We conclude that the ability to secrete erythropoietin in response to anemia is defective in many patients with end-stage liver disease, and a normal response may be restored after OLT. The results suggest that exogenous erythropoietin administration may be beneficial in anemic patients with cirrhosis and liver transplant recipients who have inappropriately low serum erythropoietin levels. (Liver Transpl 2000;6: 349-355.)

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“…The prolonged half-life following subcutaneous administration of epoetin beta suggested the possibility of increasing the interval between injections when using this route of administration, as confirmed by rHuEPO levels remaining within the target range for most of the period between injections even with once-weekly subcutaneous dosing (Besarab et al 1992). In addition, dose requirements to maintain target hemoglobin levels are significantly lower when epoetin beta is administered subcutaneously compared with intravenously (Besarab et al 1992;Kaufman et al 1998). For this reason, current treatment guidelines (Locatelli et al 2004a) recommend the subcutaneous route of administration of epoetin beta in order to minimize treatment costs.…”

Section: Epoetin Beta and Renal Anemia Clinical Pharmacologymentioning

confidence: 99%

“…Finally, different studies reported that once-weekly subcutaneous epoetin beta is as well tolerated as two-or three-times-weekly regimens (Weiss et al 2000;Locatelli et al 2002). It must also be considered that the reduced dosage requirements when epoetin is administered subcutaneously compared with intravenously may allow substantial cost savings, without compromising effectiveness or safety of therapy (Kaufman et al 1998;Besarab et al 2002;Hynes et al 2002).…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Recombinant human epoetin beta in the treatment of renal anemia

Vecchio¹,

Cavalli²,

Pozzoni³

et al. 2008

Therapy

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Cardiovascular disease is the leading cause of the poor long-term survival of patients with chronic kidney disease (CKD). Anemia complicating CKD not only impairs patients' quality of life, but is also an independent risk factor for adverse cardiovascular outcomes. The availability of recombinant human erythropoietin (rHuEPO) has greatly changed the management of anemia in CKD patients. Besides improving hemoglobin levels, rHuEPO therapy has been demonstrated to signifi cantly improve quality of life and decrease morbidity and mortality in patients with CKD. Epoetin beta, together with epoetin alfa and darbepoetin alfa, is one of the erythropoiesis-stimulating agents now available on the market. Different studies have shown that epoetin beta once-weekly administration to hemodialysis patients is as effective as threetimes-weekly administration in maintaining hemoglobin levels at equivalent weekly doses. This raises the possibility of reducing the frequency of administration of rHuEPO therapy, thus increasing the alternatives available for tailoring anemia therapy to patients needs, and at the same time reducing nursing times and treatment costs. This is expected to potentially enhance patient compliance, thus helping more patients achieve their target hemoglobin levels.

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Subcutaneous Compared with Intravenous Epoetin in Patients Receiving Hemodialysis

Abstract: In patients receiving hemodialysis, subcutaneous administration of epoetin can maintain the hematocrit in a desired target range, with an average weekly dose of epoetin that is lower than with intravenous administration.

Cited by 264 publications

References 23 publications

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

2015 Japanese Society for Dialysis Therapy: Guidelines for Renal Anemia in Chronic Kidney Disease

Erythropoietin response to post–liver transplantation anemia

Recombinant human epoetin beta in the treatment of renal anemia

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