PMID- 1574961
OWN - NLM
STAT- MEDLINE
DCOM- 19920604
LR  - 20180216
IS  - 0001-5792 (Print)
IS  - 0001-5792 (Linking)
VI  - 87 Suppl 1
DP  - 1992
TI  - Optimal route of administration of erythropoietin in chronic renal failure 
      patients: intravenous versus subcutaneous.
PG  - 16-9
AB  - Recombinant human erythropoietin (r-HuEPO) represents the therapy of choice in 
      anaemia of chronic renal failure. A number of studies have analysed the relative 
      effectiveness of r-HuEPO administered subcutaneously (s.c.) or intravenously 
      (i.v.) in haemodialysis patients. The bioavailability of s.c. r-HuEPO appears to 
      be low and the absorption of r-HuEPO variable. Nevertheless, s.c. administration 
      of r-HuEPO is more efficacious than i.v. administration, probably due to the 
      better time-averaged plasma concentrations. Patients on haemodialysis who were on 
      i.v. r-HuEPO 3 times weekly for 9 months were subsequently successfully 
      maintained on a self-administered s.c. dosage which was 50% of the i.v. 
      maintenance dosage and which was later reduced further to 30% of the weekly i.v. 
      maintenance dosage. An ongoing European multicentre study has confirmed these 
      findings and demonstrated that s.c. administration 3 times weekly and once daily 
      was as effective as i.v. administration 3 times weekly. Both these s.c. regimens 
      resulted in a significant dosage reduction (30%) compared with the i.v. regimen. 
      The study also found that once weekly s.c. dosing was as effective as 3 times 
      weekly i.v. dosing but did not result in a dosage reduction. Other studies on the 
      optimization of s.c. r-HuEPO in patients on continuous ambulatory peritoneal 
      dialysis demonstrated that haemoglobin levels following s.c. r-HuEPO 
      administration (60 U/kg twice weekly) can be further increased by 2 ml iron 
      dextran (containing 50 mg/ml iron) administered i.v. 7-9 weeks after the start of 
      therapy. Studies on the site of s.c. injection reveal that injection into the 
      thigh results in more rapid absorption, higher peak concentrations and greater 
      bioavailability than injection into the arm or abdomen. Data also demonstrate the 
      economic advantage of s.c. r-HuEPO in high-risk patients.
FAU - Horl, W H
AU  - Horl WH
AD  - Universitats-Klinik und Poliklinik, Homburg a.d. Saar, BRD.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Switzerland
TA  - Acta Haematol
JT  - Acta haematologica
JID - 0141053
RN  - 11096-26-7 (Erythropoietin)
SB  - IM
MH  - Anemia/*drug therapy/etiology
MH  - Biological Availability
MH  - Erythropoietin/*administration & dosage/pharmacokinetics/therapeutic use
MH  - Humans
MH  - Injections, Intravenous
MH  - Injections, Subcutaneous
MH  - Kidney Failure, Chronic/*complications
RF  - 20
EDAT- 1992/01/01 00:00
MHDA- 1992/01/01 00:01
CRDT- 1992/01/01 00:00
PHST- 1992/01/01 00:00 [pubmed]
PHST- 1992/01/01 00:01 [medline]
PHST- 1992/01/01 00:00 [entrez]
AID - 10.1159/000204783 [doi]
PST - ppublish
SO  - Acta Haematol. 1992;87 Suppl 1:16-9. doi: 10.1159/000204783.