Two years experience of daily self-administered subcutaneous erythropoietin.
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.
Granolleras
C
C
Department of Nephrology, University Hospital, Nîmes, France.
Branger
B
B
Deschodt
G
G
Shaldon
S
S
Nonnast-Daniel
B
B
Pollok
M
M
D000328:Adult; D000368:Aged; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D006435:Renal Dialysis / Q000009:adverse effects*; D012646:Self Administration / Q000379:methods; D013997:Time Factors
D011994:Recombinant Proteins; D004921:Erythropoietin