THE FUTURE OF RHUEPO

Since the introduction of recombinant human erythropoietin (r-HuEPO) 9 years ago, there have been tremendous physiological improvements in p atients with various anaemias due to absolute and relative erythropoie tin (Epo) deficiencies. However: not all patients that could benefit f rom r-HuEPO are being treated, not all are responding who should be re sponding, and most dialysis patients (who comprise the single largest group of treatment recipients) are being inadequately treated. The fut ure of r-HuEPO will depend upon whether clinicians can optimize the us e of r-HuEPO and determine what should be the optimal haematocrit. The se issues will, in turn, depend upon whether three interdependent vari ables are addressed: the need for more scientific studies to evaluate various aspects of the use and effectiveness of r-HuEPO the need for p hysician education to better understand the role of r-HuEPO in optimiz ing health in patients with anaemia in chronic renal failure and in th e anaemia of chronic disease; and the need for less costly r-HuEPO the rapy so that more patients can be treated and receive optimal therapy. Better use of r-HuEPO could result in significantly improved morbidit y and perhaps improved survival of patients with Epo-deficient anemias .