EFFICACY OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ADMINISTERED SUBCUTANEOUSLY TO CAPD PATIENTS ONCE WEEKLY

Objective: The purpose of the present study was to compare the dosage requirements of recombinant human erythropoietin (rHuEPO) administered subcutaneously (SC) either one or three times weekly. Design: A rando mized, prospective study. Setting:The patients were recruited from two university hospitals and five county hospitals. Patients: Thirty-thre e anemic patients on continuous ambulatory peritoneal dialysis (CAPD) treatment for endstage renal failure completed the study. Intervention s: Initially, all were treated with rHuEPO SC three times a week until hemoglobin blood levels (Hb) remained constant between 105 and 121 g/ L for three months. Following randomization, 17 patients continued the same treatment schedule (group A), while 16 patients received the sam e dose, but administered only once weekly for three months (group B). Main Outcome Measures: The Hb levels and rHuEPO doses at the start and at the end of the three-month study period. Results: In group A the m edian Hb at randomization was 118 g/L (109 - 119) (25 - 75 percentiles ) and, after three months, was 113 g/L (106 - 119)(p = 0.13), while in group B the median Hb was 114 g/L (108 - 119) and 114 g/L (106 - 120) , respectively (p = 0.50). In group A the weekly dose of rHuEPO remain ed virtually unchanged during the study period, 65 (55 - 86) and 66.3 (55 - 95) U/kg/week, respectively, while in group B it was increased f rom 60.2 (46 - 88) to 77 (60 - 90) U/kg/week. The 22% increase (p = 0. 03) took place during the last two weeks. Conclusions: Our findings in dicate that a once-weekly SC dosing regimen of rHuEPO in anemic CAPD p atients was equally effective in maintaining a stable hemoglobin level as a thrice-weekly dosing regimen.