SUBCUTANEOUS VERSUS INTRAVENOUS ADMINISTRATION OF ERYTHROPOIETIN IMPROVES ITS EFFICIENCY FOR THE TREATMENT OF ANEMIA IN HEMODIALYSIS-PATIENTS

Recombinant human erythropoietin (rHuEpo) seems to be more efficient w hen given subcutaneously (SC) instead of intravenously (TV) for therap y of anaemia in haemodialysis patients. This was a crossover study des igned to assess the efficiency of rHuEpo when given SC rather than IV in a 1 year follow-up. Sixteen patients received IV rHuEpo for 6 month s, then SC rHuEpo for 6 months. They were four males and 12 females wi th a mean age of 56 years (range 15-82). Haemoglobin concentration ([H b]) was kept at 10 g/dl and transferrin saturation (TS) at more than 2 5%, Mean [Hb] was 9.7+/-1.0 g/dl with IV rHuEpo and 9.9 +/- 0.9 g/dl w ith SC rHuEpo (NS). Transferrin saturation was 27% before rHuEpo, 31% with IV rHuEpo and 34% with SC rHuEpo (NS vs IV rHuEpo). Serum ferriti n was 691+/-113 ng/ml before rHuEpo, 652+/-94 ng/ml with IV rHuEpo and 997+/-132 ng/ml with SC rHuEpo (P<0.05 vs IV rHuEpo). Intact parathyr oid hormone was 354+/- 83 pg/ml before rHuEpo, 201+/-63 pg/ml with IV rHuEpo and 122+/-33 pg/ml with SC rHuEpo (NS vs TV rHuEpo). Doses of I V rHuEpo were 156+/-24 U/kg/week and SC rHuEpo 74+/-13 U/kg/week (i.e. a saving of 53%; P<0.001). We conclude that subcutaneous administrati on of rHuEpo is twice as efficient as IV rHuEpo in patients with good functional iron reserve.