Dosage requirement of erythropoietin can be reduced with more frequent administration

Abstract

In short-term studies, once weekly and twice weekly dosing regimens of erythropoietin (EPO) have both been shown to be effective in correcting anaemia in dialysis patients. However, the optimal dosing frequency has yet to be determined. The long-term effects of EPO given by more frequent divided doses in 10 stable haemodialysis patients were studied. The patients achieved a stable haemoglobin level for at least 3 months prior to the study. The frequency of administration was altered from 4000 units once weekly to 2000 units twice weekly in seven patients, from 4000 units once every 10 days to 2000 units twice weekly alternating with 2000 units once weekly in two patients, and from 4000 units fortnightly to 2000 units once weekly in one patient. After the conversion, EPO dosage was adjusted in order to maintain the haemoglobin at the preconversion level. At the end of 28 weeks, the mean haemoglobin level remained unchanged. However, the mean dosage requirement of EPO reduced from 3400 units per week to 2500 units per week (P = 0.019). This represents a significant 26% reduction in dosage and cost. It was concluded that subcutaneous administration of frequent small doses of EPO is a more cost-effective way of correcting anaemia in haemodialysis patients.