title: Administration of the same dose of epoetin-beta intravenously and subcutaneously to patients with renal anaemia.
abstract: OBJECTIVE
  Subcutaneous (s.c.) administration of erythropoietin (EPO) is recommended over the intravenous (i.v.) route to reduce doses and costs. Optimal iron treatment is important for the optimal EPO effect. This study investigated whether the haemoglobin (Hb) level of a single patient could be preserved with the same dose of EPO given i.v. as given s.c.
  
  
  METHODS
  One-hundred and forty-five haemodialysis patients with the same weekly EPO dose s.c. for 3 months and a stable Hb (maximum fluctuation of 1 mmol/l) were randomized in a crossover study to group A (4 months i.v. then 4 months s.c. EPO) or group B (4 months s.c. then 4 months i.v. EPO, with unchanged EPO dose). Ferritin had to be 300-800 μg/l or transferrin saturation ≥ 20%. Patients with a fall in Hb >1 mmol/l were withdrawn.
  
  
  RESULTS
  Ferritin and transferrin saturation remained within the target range, and mean Hb in the range of 1 mmol/l. Mean EPO doses were unchanged in both groups, and no difference was found between the dropouts due to Hb fall >1 mmol/l in the i.v. and s.c. groups during the first period of the trial.
  
  
  CONCLUSIONS
  In iron-replete haemodialysis patients the same EPO dose given intravenously is just as effective as given subcutaneously.
authors: Department of Medicine, Hospital Lillebrlt, Fredericia, Denmark. gudrun.kjaer.steffensen@slb.regionsyddanmark.dk
authors: Gudrun K
authors: GK
authors: Steffensen
authors: Ove
authors: O
authors: Stergaard
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D018592:Cross-Over Studies; D004921:Erythropoietin / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D007501:Iron / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications; D018709:Statistics, Nonparametric
chemical_list: D006454:Hemoglobins; D010281:Parathyroid Hormone; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron