Enterally dosed recombinant human erythropoietin does not stimulate erythropoiesis in neonates.
OBJECTIVE
Human fetuses and neonates ingest erythropoietin (Epo) when they swallow amniotic fluid, colostrum, and human milk. This study was designed to determine whether enterally dosed recombinant Epo (rEpo) stimulates erythropoiesis in preterm neonates.


METHODS
Preterm infants (<1500 g birth weight) were randomly assigned to receive feedings supplemented with either rEpo (1000 U/kg per day) or placebo for 14 days (n=36). Reticulocyte counts, serum Epo concentrations, hematocrit, and zinc protoporphyrin to heme ratios were measured at baseline and after 7 and 14 days of study drug administration. Transfusion guidelines were followed. Transfusion requirements, medications, feeding tolerance, and clinical diagnoses were documented.


RESULTS
Enteral rEpo was well tolerated. There were no differences in erythropoietic indexes based on treatment group. Serum Epo concentrations were not different in the treatment versus placebo group, nor were transfusion requirements.


CONCLUSIONS
Enterally dosed rEpo (1000 U/kg/day) does not significantly influence erythropoiesis or iron utilization when given for a 2-week period, nor does it elevate the serum Epo concentration in preterm or term infants. Oral administration of rEpo is not an effective substitute for parenteral administration.
D000284:Administration, Oral; D001803:Blood Transfusion; D004750:Enteral Nutrition; D004791:Enzyme Inhibitors / Q000097:blood; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology*; D006400:Hematocrit; D006418:Heme / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D011446:Prospective Studies; D011524:Protoporphyrins / Q000097:blood; D011994:Recombinant Proteins; D017701:Reticulocyte Count; D013997:Time Factors
D004791:Enzyme Inhibitors; D011524:Protoporphyrins; D011994:Recombinant Proteins; D004921:Erythropoietin; C017803:zinc protoporphyrin; D006418:Heme