WHAT IS THE OPTIMUM FREQUENCY OF ADMINISTRATION OF RHUEPO FOR CORRECTING ANEMIA IN HEMODIALYSIS-PATIENTS

The efficacy of recombinant human erythropoietin (r-HuEPO) in correcti ng the anemia of uremic patients is now widely recognized. However, th e optimization of the r-HuEPO dosing regimen-a major concern in reduci ng cost and side effects-remains a controversial issue. In this regard , subcutaneous r-HuEPO administration offers the most interesting rout e, providing the best cost-to-benefits ratio in uremic patients. Nonet heless, doubt still persists when it comes to the question of the opti mum frequency of administration. This multicenter study was designed t o answer this concern by comparing the efficacy, of subcutaneous admin istration with IV r-HuEPO treatment in stable patients, and to determi ne the optimum weekly dosing regimen. One hundred and sixteen stable h emodialysis (HD) patients receiving IV r-HuEPO on a regular basis were converted and randomly allocated to one of four groups-IV3, SC1, SC3, and SC7-and then treated for 16 weeks. The r-HuEPO dose was adjusted to maintain a hemoglobin (Hb) level between 9-12 g/dl. In all groups, the efficacy of r-HuEPO administration was maintained Three weekly sub cutaneous injections (SC3) offered the best efficacy-to-dose ratio, pe rmitting a 30% r-HuEPO dose reduction in about 70% of patients equival ent to daily SC injections (SC7), while no EPO sparing effect was obse rved with once per week injection. The incidence of side effects, main ly hypertension, was similar in all groups. We conclude that thrice we ekly subcutaneous injections seem to be the optimum dosing route regim en for r-HuEPO administration in hemodialysis patients.