Use of recombinant human erythropoietin in combination with parenteral iron in the treatment of postpartum anaemia

Breymann, Christian; Zimmermann, Roland; Huch, R.; Huch, A.

doi:10.1046/j.1365-2362.1996.109261.x

Cited by 58 publications

(40 citation statements)

References 36 publications

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“…No adverse effects were observed during the study. Similar conclusions were drawn by Breyman et al: rHuEpo 300 U/kg + IV iron 100 mg once followed by oral iron significantly increased Hb but no correction of ferritin levels was observed after two weeks of treatment 22 . Anemia due to heavy bleeding during delivery should be corrected without delay.…”

Section: Experience To Date With IV Iron Administration In the Perisusupporting

confidence: 87%

Perisurgical Intravenous Iron Therapy

Beris

1999

Transfus Alt Transfus Med

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SUMMARY There is no doubt that the developments in detecting viral antigens and antibodies, and very recently viral RNA or DNA, in donor blood, have greatly increased the safety of blood transfusion1. However, while it is generally agreed that a residual risk of transmitting viral infections by blood still exists 2, we do not know if Creutzfeld‐Jakob disease or its new form – undetectable with current screening methods – are transmitted by transfusion or not 3. Furthermore, the long‐term immunomodulatory effect of allogeneic blood on the patient is not known. For these reasons, a more conservative transfusion practice is advocated; physicians must do all they can to decrease allogeneic blood transfusion, especially in patients without blood disease who, because of a significant acute blood loss (e.g. during major surgery), are likely to receive allogeneic blood. In this paper we will discuss the use of intravenously administered iron in the perisurgical setting as a means of accelerating erythropoiesis in an attempt to decrease transfusion requirements.

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Section: Experience To Date With IV Iron Administration In the Perisusupporting

confidence: 87%

Perisurgical Intravenous Iron Therapy

Beris

1999

Transfus Alt Transfus Med

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“…Iron sucrose alone or in combination with recombinant human erythropoietin (rhEPO) has been successfully used in the treatment of anemia in pregnancy [5][6][7][8] as well as in the puerperium [9,10] .…”

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confidence: 99%

Selective Use of Recombinant Human Erythropoietin in Pregnant Patients with Severe Anemia or Nonresponsive to Iron Sucrose Alone

2009

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Objective: To evaluate the effectiveness of a stepwise use of recombinant human erythropoietin (rhEPO) in pregnant patients with severe anemia or nonresponsive to intravenously administered iron only. Methods: All subjects had iron deficiency anemia, i.e., a hemoglobin (Hb) level <10.0 g/dl and ferritin ≤15 μg/l. Patients with an Hb level ≥9.0 g/dl and <10.0 g/dl received 200 mg iron sucrose intravenously twice weekly. If response to therapy was poor, patients additionally received 10,000 U rhEPO twice weekly. Patients with an Hb level <9.0 g/dl primarily received iron sucrose and rhEPO likewise. Results: Of the 84 patients, 59 had a baseline Hb level between 9.0 and 9.9 g/dl, of whom 32 responded poorly, thus receiving additional rhEPO. Twenty-five patients had a baseline Hb level <9.0 g/dl. The overall Hb level after therapy was 11.0 g/dl (±0.5, range 10.0–12.6 g/dl). Mean duration of therapy was 3.5 weeks (7 infusions). Conclusion: This study shows an effective treatment regimen for patients with various degrees of anemia in pregnancy. Iron sucrose is a safe and effective treatment option. In cases of severe iron deficiency anemia or poor response to parenteral iron therapy additional administration of rhEPO might be considered. However, the mechanism for not responding to intravenous iron therapy despite iron deficiency anemia still remains unclear to a large extent.

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“…Moreover, adequate iron stores is an important prerequisite for a successful rHuEPO treatment [21]. Seven out of 26 patients (27%) of this study showed little or no response to rHuEPO combined with parenteral iron therapy.…”

Section: Discussionmentioning

confidence: 68%

“…rHuEPO has been tested as potential therapy in various maternal disorders during pregnancy. These include: end-stage renal disease [19], antepartum iron deficiency anemia [20], postpartum anemia [9,21], as well as anemia of pregnant women with chronic hematological disorders [13,14], and various more rare clinical conditions [11][12]. These studies showed that rHuEPO administration might be used to treat certain pregnancy anemias by stimulating maternal erythropoiesis or as an alternative for patients refusing blood transfusion.…”

Section: Discussionmentioning

confidence: 99%

Erythropoietin in the Treatment of Iron Deficiency Anemia during Pregnancy

Sifakis

Angelakis

Vardaki

et al. 2001

Gynecol Obstet Invest

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The aim of this study was to investigate the efficacy of recombinant human erythropoietin (rHuEPO) combined with parenteral iron, in the treatment of moderate and severe iron deficiency anemia during pregnancy. Twenty-six pregnant women, who had been ineffectively treated with iron supplementation alone for at least 8 weeks, were enrolled. They met the following criteria for inclusion in the study: hemoglobin (Hb) concentration <8.5 g/dl, evidence of iron deficiency anemia, and absence of other pregnancy complications, or severe systemic diseases. The treatment protocol comprised of a combination therapy with 150 IU/kg rHuEPO subcutaneously three times per week and 100 mg parenteral iron daily, for a total period of 4 weeks. Nineteen out of 26 women (73%) showed a quick response, with Hb reaching normal levels within the first 2 weeks of treatment. They displayed an average of 3.17 g/dl increase in Hb concentration during the total period of therapy, with 3.0 g/dl increase within the first 2 weeks. In 5 women (19.2%) there was no significant increase in Hb levels, while in 2 women (7.6%) a further decline in Hb concentration was observed, that necessitated a blood transfusion. In conclusion, rHuEPO combined with parenteral iron is an effective treatment for moderate and severe iron deficiency anemia during pregnancy, with minimal adverse or side effects. It may serve as an alternative to blood transfusion, or in cases of resistant anemia that are not effectively treated by iron supplementation alone. However, further studies are needed to investigate the poor response observed in about 25% of treated patients.

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Use of recombinant human erythropoietin in combination with parenteral iron in the treatment of postpartum anaemia

Cited by 58 publications

References 36 publications

Perisurgical Intravenous Iron Therapy

Perisurgical Intravenous Iron Therapy

Selective Use of Recombinant Human Erythropoietin in Pregnant Patients with Severe Anemia or Nonresponsive to Iron Sucrose Alone

Erythropoietin in the Treatment of Iron Deficiency Anemia during Pregnancy

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