EFFICACY AND COST-ANALYSIS OF TREATING VERY-LOW-BIRTH-WEIGHT INFANTS WITH ERYTHROPOIETIN DURING THEIR FIRST 2 WEEKS OF LIFE - A RANDOMIZED,PLACEBO-CONTROLLED TRIAL

Objective: We hypothesized that using a higher dose of erythropoietin (Epo) and starting treatment on the first day of life would reduce the transfusion requirements of ventilator-dependent and non-ventilator-d ependent very low birth weight (VLBW) infants. Moreover, we hypothesiz ed that this treatment would be cost-effective. Methods: We randomly a ssigned 20 ill newborn VLBW infants to receive either Epo (200 units/k g per day) or placebo during their first 2 weeks of life, The caregive rs were unaware of the treatment assignments, and erythrocyte transfus ions were administered according to hematocrit and signs of anemia, Re sults: On day 1, reticulocyte counts and hematocrits were similar in t he two groups, During the subsequent 2 weeks, reticulocyte counts of t he placebo recipients fell significantly below those of the Epo recipi ents, but hematocrits in the two groups did not differ, More transfusi ons were received by the placebo recipients (mean = 1.4 per patient) t han by the Epo recipients (mean = 0.2 per patient; p <0.01). No advers e effects of Epo were noted, and the costs in the placebo group exceed ed those in the Epo group, Conclusions: We conclude that administratio n of Epo to VLBW infants during the first 2 weeks of life results in f ewer transfusions and is cost-effective.