The efficacy of once weekly compared with two or three times weekly subcutaneous epoetin beta: results from a randomized controlled multicentre trial

Background, Anaemia in haemodialysis patients can be effectively treated wi th erythropoietin. We investigated whether subcutaneous (SC) epoetin beta a dministered once weekly was as effective as the same weekly dosage given in two to three divided doses. Methods. One hundred and fifty-eight patients (delivered Kt/V > 1.0, where K = dialyser-renal urea clearance, t = dialysis time and V = filtration vol ume, obtained by urea kinetic modelling) were randomized to treatment with SC epoetin beta either once weekly (n = 118), or to their original dosage t wo or three times weekly (control group, n = 40) for 24 weeks. All patients received intravenous iron supplementation when necessary. Results. Eight-eight patients in the once weekly group and 30 patients in t he control group were treated for at least 16 weeks and are included in the analysis. Stable haemoglobin levels were maintained without epoetin dose i ncreases in 73% of patients in both groups. Mean haemoglobin levels at rand omization and after 16 and 24 weeks were 11.4, 11.1 and 11.1 g/dl, respecti vely, in the once weekly group compared with 11.2, 11.3 and 11.2 g/dl, resp ectively, in the control group. The mean weekly epoetin beta dosages at ran domization and after 16 and 24 weeks were 102, 103 and 106 IU/kg bodyweight , respectively, in the once weekly group compared with 109, 109 and 115 IU/ kg bodyweight. respectively, in the control group, No statistically signifi cant between-group differences were apparent for changes in haemoglobin lev els or epoetin beta dosages at week 24. Conclusions, Once weekly SC administration of epoetin beta is as safe and e ffective in maintaining haemoglobin levels in stable haemodialysis patients as two or three times weekly administration of the same total dose. By usi ng the once weekly regimen, patients can avoid up to 103 injections per yea r. This would reduce clinic time for patients who do not self administer, a nd may also encourage self-administration and improve overall compliance.