Therapeutic applications of erythropoietin

A number of clinical circumstances have been identified which are characterized by an often profoundly depressed rate of erythropoiesis (Table 10.7). Many, if not all, such conditions could 

The product displays a terminal half-life of 4-12 h and 8-22 h after i.v. and s.c. administration respectively. Dosage regime is dependent upon the exact disease condition, but generally involves administration once/several times weekly. Various clinical trials investigating various indications proved product efficacy in the treatment and prevention of anaemia, with increased haemocrit values observed. 

Common side effects include increased blood pressure, increased respiratory infections and increased platelet counts. Serious (rare) side effects were most often related to cardiovascular complications. Neorecormon is marketed by Roche. 

EPO was first used therapeutically in 1989 for the treatment of anaemia associated with chronic kidney failure. This anaemia is largely caused by insufficient endogenous EPO production by the diseased kidneys. Prior to EPO approval this condition could only be treated by direct blood transfusion. It responds well, and in a dose-dependent manner, to the administration of recombinant human EPO (rhEPO). The administration of EPO is effective, both in the case of patients receiving dialysis and those who have not yet received this treatment. 

Administration of EPO doses ranging from 50 to 150 IU kg-1 three times weekly is normally sufficient to elevate the patient s haematocrit values to a desired 32-35 per cent. (Haematocrit refers to packed cell volume , i.e. the percentage of the total volume of whole blood that is composed of erythrocytes.) Plasma EPO concentrations generally vary between 5 and 25 IU U1 in healthy individuals. One IU (international unit) of EPO activity is defined as the activity that promotes the same level of stimulation of erythropoiesis as 5 mmol of cobalt. 

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