Weiss L, Svensson B, Clyne N, Devino J, Frisenette-Fich C,
Kurkus J
Is subcutaneous erythropoietin administered once a week for
stable hemodialysis patients sufficient? Results from a Swedish
multicenter trial
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1468 1996
Three conclusions may be drawn from the large series of studies comparing iv
to sub-q EPO in recent years, 1) Generally sub-q dosing results in a 30-40%
decrease in total dose requirement, 2) The response is heterogeneous, some
patients do just as well with iv EPO, 3) Patients prefer iv dosing. Because
of this final point, there is some interest in evaluating once weekly dosing
protocols for sub-q EPO. The purpose of this study was to compare once
weekly
EPO sub-q, to twice or thrice weekly administration.
128 stable hemodialysis patients were randomized to receive their weekly EPO
in once, twice or thrice weekly doses. After 24 weeks of treatment, there
were 80 patients in the once weekly group, and 23 patients receiving
multiple
(2-3) doses. There was no significant difference between once daily, and the
other regimens in terms of Hct or EPO dose. The authors conclude that once
weekly dosing is as effective as other methods.
Comment: This is a very encouraging result, and is consistent with
findings
from the Emory group presented at the 1996 ASN meeting. Once weekly dosing
would certainly be more tolerable for patients, and less costly in terms of
nursing administration.
(Stephen Fishbane, M.D., Winthrop University Hospital, Mineola, NY)
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Am Soc Nephrol
CRF by problem area :
Anemia/Erythropoietin/Iron