Experience with Low Dose Intravenous and Subcutaneous Administration of Recombinant Human Erythropoietin

1990 ◽  
Vol 10 (5) ◽  
pp. 404-408 ◽  
Author(s):  
Lawrence P. McMahon ◽  
John K. Dawborn
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Low Dose ◽  
Subcutaneous Administration ◽  
Human Erythropoietin

Hemodynamic effects of recombinant human erythropoietin on the central nervous system after subarachnoid hemorrhage: reduction of microcirculatory impairment and functional deficits in a rabbit model

2008 ◽  
Vol 109 (6) ◽  
pp. 1155-1164 ◽  
Author(s):  
Amanda M. Murphy ◽  
Anargyros Xenocostas ◽  
Pria Pakkiri ◽  
Ting-Yim Lee
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Recombinant Human Erythropoietin ◽  
Low Dose ◽  
Saline Group ◽  
High Dose ◽  
Hemodynamic Effects ◽  
Neurological Outcomes ◽  
Human Erythropoietin

Object The authors investigated the hemodynamic effects of recombinant human erythropoietin (rhEPO) after subarachnoid hemorrhage (SAH) in rabbits. Methods The authors used male New Zealand White rabbits in this study divided into the following groups: SAH plus saline (16 rabbits), SAH plus low-dose rhEPO (16 rabbits; 1500 IU/kg on Day 0 and 500 IU/kg on Days 2 and 4), SAH plus high-dose rhEPO (10 rabbits; 1500 IU/kg on Days 0, 2, 4, and 6), and sham (6 rabbits). Computed tomography perfusion studies and CT angiography were performed for 1 hour after SAH on Day 0, and once each on Days 2, 4, 7, 9, and 16 after SAH. Assessments of neurological function and tissue histology were also performed. Results The mortality rate was significantly lower after rhEPO treatment (12%) than after saline treatment (44%) (p < 0.05). Neurological outcomes in the low-dose and high-dose rhEPO groups were better than in the saline group after SAH (p < 0.05), and the cerebral blood flow in the high-dose rhEPO group was greater than that in the saline group (p < 0.05). The mean transit time was significantly lower on Days 2 and 4 in the low-dose and high-dose rhEPO groups than in the saline group, but increased significantly on Day 7 in both groups (p < 0.05). The hematocrit increased significantly from baseline values in the high-dose and low-dose rhEPO groups on Days 4 and 7, respectively (p < 0.05). Conclusions Treatment with rhEPO after experimental SAH is associated with improved cerebral blood flow and microcirculatory flow as reflected by lower mean transit times. Improved tissue perfusion correlated with reduced mortality and improved neurological outcomes. Further investigation of the impact of increasing hematocrit on hemodynamic changes is needed.

Intraperitoneal Administration of Recombinant Human Erythropoietin

1992 ◽  
Vol 12 (4) ◽  
pp. 378-383 ◽  
Author(s):  
Leon A.M. Frenken ◽  
Dirk G. Struijk ◽  
Peter J.W. Coppens ◽  
Roland G.W.L. Tiggeler ◽  
Raymond T. Krediet ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Intraperitoneal Administration ◽  
Subcutaneous Administration ◽  
Hemoglobin Concentration ◽  
Treated Group ◽  
Efficacy And Safety ◽  
University Hospitals ◽  
Safe Alternative ◽  
Human Erythropoietin ◽  
Dialysis Solution

Objective To determine the efficacy and safety of intraperitoneal administration of recombinant human erythropoietin (rHuEPO) in continuous ambulatory peritoneal dialysis (CAPD) patients compared to subcutaneous rHuEPO. Design Prospective analysis of an open, nonrandomized investigation. Setting Outpatient CAPD clinics in two university hospitals. Patients Nine adult CAPD patients receiving rHuEPO intraperitoneally and 8 patients receiving rHuEPO sub-cutaneously. Intervention One hundred units of rHuEPO per kilogram of body weight were administered three times a week for 8 weeks or until the target hematocrit of 35% was reached. Thereafter, dosages of rHuEPO were adjusted for response. Intraperitoneal rHuEPO was administered in 1 L of dialysis solution during the night. Measurements Efficacy was assessed by measuring the increase in hemoglobin. Tolerance was assessed by monitoring side effects. Results In the first 8 weeks of treatment hemoglobin concentration increased from 64.5±12.9 glL to 98.3±16.1 g/L (p<0.0005) in the intra peritoneally treated group. In the subcutaneously treated group hemoglobin increased significantlyfaster (p<0.05) from 72.5±4.8 g/L to 119.2±11.3 g/L (p<0.0005) in the same period. Antihypertensive medication had to be increased or instituted in most of the patients in both groups. The incidence of peritonitis in the intraperitoneally treated group was not increased when compared to the pretreatment incidence. Conclusions Subcutaneously administered rHuEPO is superior to intraperitoneally administered rHuEPO with regard to the required dosages. However, the results of this study show that intraperitoneal administration of rHuEPO might be a convenient and safe alternative when subcutaneous administration is undesirable.

Effects of Subcutaneous Recombinant Human Erythropoietin in Patients on Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 538-540 ◽  
Author(s):  
Bruno Di Paolo ◽  
Alvaro Marini ◽  
Barbara Fiederling ◽  
Lorenzo Di Liberato ◽  
Patrizia Santarelli ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Recombinant Human Erythropoietin ◽  
Cerebral Oxygenation ◽  
Subcutaneous Administration ◽  
Well Being ◽  
Dramatic Improvement ◽  
Human Erythropoietin ◽  
Red Cell Indices ◽  
Main Components

The use of recombinant human erythropoietin (rHuEPO) has revolutionized the treatment of renelanemia, but the dose regimens, the optimal frequency, and the effects on other target organs like the central nervous systems (CNS) are still under discussion. We designed a prospective, ongoing study with 10 stable continuous ambulatory peritoneal dialysis (CAPO) patients (6 males, 4 females; mean age 64.4±7.8 years), with a pretreatment hemoglobin (Hb) <7.0 901. and requiring regular blood transfusions. Seven patients were treated with 4000 U rHuEPO once weekly (Eritrogen, Boehringer Mannhelm), 2 patients received 4000 U every 5 and 8 days, and the last one 4000 U every 10 days. The target hematocrit was 33% and Hb 10.0 g%. The CNS activity was recorded as visual (YEP), brainstem (BAER), and somatosensory (SEP)-evoked potentials. The mean Hb concentration Increased from 6.9± 1.2g% to 10.3± 1.6 g% (p<0.001) over 8 weaks. There were no significant changes In urea, creatinine, and potassium levels, and urine output. rHuEPO Induced a decrease In latency of P100 YEP, In the four main components of BAER, and In the P27–N35 Intertime of SEP. Parallel to the Improvement of red cell Indices, patients experienced a dramatic Improvement In well-being. The subcutaneous administration of a single vial of rHuEPO Is safe, convenient, and Inexpensive In CAPO. The role of rHuEPO treatment In Improving the electro-physiological brain function In uremic and anemic patients remains to be studied and may not necessarily be based on Improved cerebral oxygenation.

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