USE OF RECOMBINANT HUMAN ERYTHROPOIETIN (RH-EPO) IN THE TREATMENT OF ANEMIA IN HEMODIALYSIS PATIENTS : A MULTICENTER ITALIAN EXPERIENCE

BACKGROUND AND METHODS: After the phase I-II clinical trials in 1986, several studies on the use of rHuEPO in the treatment of anemia of renal failure have been carried out and the drug has been introduced into clinical practice. In the present article we analyze the results of recombinant human erythropoietin (rh-EPO) therapy administered intravenously (i.v.) to 759 patients in several italian dialysis centers. RESULTS AND CONCLUSIONS: Data analysis confirms the erythropoietic efficacy of the drug (mean Hct increase from 22.1 +/- 2.8 to 31.5 +/- 3.0%) as well as the generalized Italian position toward a cautious correction of anemia (the increase is achieved in 6 months). Such a therapeutic approach is consistent with the chronic anemia of the dialysis patient. Low doses are widely used (40-100 IU/kg x three times a week). Analysis of adverse events seems to point out that some correlate directly with the drug and are therefore difficult to eliminate (flu-like syndrome). On the other hand, certain adverse events seem to correlate with the modalities of drug use (dosage, time required for the Hct increase). The possible advantages of subcutaneous administration are also described.