Efficacy of recombinant human erythropoietin administered subcutaneously to CAPD patients once weekly

Objective: The purpose of the present study was to compare the dosage requirements of recombinant human erythropoietin (rHuEPO) administered subcutaneously (SC) either one or three times weekly. Design: A randomized, prospective study. Setting:The patients were recruited from two university hospitals and five county hospitals. Patients: Thirty-three anemic patients on continuous ambulatory peritoneal dialysis (CAPD) treatment for endstage renal failure completed the study. Interventions: Initially, all were treated with rHuEPO SC three times a week until hemoglobin blood levels (Hb) remained constant between 105 and 121 g/L for three months. Following randomization, 17 patients continued the same treatment schedule (group A), while 16 patients received the same dose, but administered only once weekly for three months (group B). Main Outcome Measures: The Hb levels and rHuEPO doses at the start and at the end of the three-month study period. Results: In group A the median Hb at randomization was 118 g/L (109 - 119) (25 - 75 percentiles) and, after three months, was 113 g/L (106 - 119)(p = 0.13), while in group B the median Hb was 114 g/L (108 - 119) and 114 g/L (106 - 120), respectively (p = 0.50). In group A the weekly dose of rHuEPO remained virtually unchanged during the study period, 65 (55 - 86) and 66.3 (55 - 95) U/kg/week, respectively, while in group B it was increased from 60.2 (46 - 88) to 77 (60 - 90) U/kg/week. The 22% increase (p = 0.03) took place during the last two weeks. Conclusions: Our findings indicate that a once-weekly SC dosing regimen of rHuEPO in anemic CAPD patients was equally effective in maintaining a stable hemoglobin level as a thrice-weekly dosing regimen.