USE OF ERYTHROPOIETIN IN PREMATURE NEONATES - CONTROVERSIES AND THE FUTURE

OBJECTIVE: To review and evaluate current research on the use of recom binant human erythropoietin (rhEPO) for the treatment of anemia of pre maturity (AOP). DATA SOURCES: A MEDLINE search (1985-September 1994) w as used to identify and retrieve pertinent data about erythropoietin's use in premature neonates. Bibliographies in the relevant literature and International Pharmacy Abstracts were reviewed as well. STUDY SELE CTION: The authors extrapolated data from trials and other literature in which the entire paper or abstract was published. Because of the pa ucity of data on the use of rhEPO in neonates, all available literatur e was reviewed and cited, regardless of study methodology. DATA SYNTHE SIS: Most data support that rhEPO is efficacious in treating AOP. Unti l recently, the published investigations have included only small numb ers of patients. Larger, multicenter, placebo-controlled trials sugges t that infants weighing less than 1500 g benefit from rhEPO therapy. Q uestions remain concerning the rhEPO dose and nutrient requirements fo r optimal efficacy. CONCLUSIONS: Published clinical trials that have e xamined the efficacy of rhEPO in the treatment of AOP vary considerabl y with regard to methodology, rhEPO dose, nutrient doses, and outcome measurement. At present, many questions remain to be answered includin g ascertaining rhEPO's long-term benefit versus cost/risk as well as i ts potential contribution to improving the care of the premature neona te.