Epoetin Alfa

Abstract

Recombinant human erythropoietin (epoetin alfa) has been used in clinical settings for more than a decade. Its indications have expanded considerably from its original use as hormone therapy in the treatment of anemia in adults with chronic kidney disease. Since the introduction of epoetin alfa, a greater understanding of anemia pathophysiology and the interactions of erythropoietin, iron, and erythropoiesis has been elucidated. Anemia is now independently associated with increased mortality and disease progression. Potential survival benefits associated with correction of anemia in various patient populations are leading to consideration of earlier, more aggressive treatment of mild to moderate anemia with epoetin alfa. Moreover, this agent's therapeutic use may extend beyond currently accepted roles. Epoetin alfa is undergoing evaluation with promising results in a variety of new clinical settings, including anemia associated with congestive heart failure, ribavirin-interferon alfa treatment of hepatitis C virus infection, and critical illness. Preclinical studies also have established erythropoietin and its recombinant equivalent to be a pleiotropic cytokine with antiapoptotic activity and neuroprotective actions in the central nervous system. The therapeutic potential of epoetin alfa appears yet to be fully realized.

Erythropoietin Induced Tumour Mass Reduction in Murine Lymphoproliferative Models

“…Recombinant erythropoietin (rHuEPO) is widely used in clinical practice in the treatment of several types of anaemia [1,2,3,4]. We observed that patients with end-stage multiple myeloma (MM) treated with EPO live longer than expected, despite their original poor prognostic features [5, 6].…”

Human erythropoietin gene delivery for cardiac remodeling of myocardial infarction in rats

“…Beyond the conventional erythropoietic activity, EPO was recently identified as a pleiotropic organ-protective cytokine [10–13]. Because of the resolution of myocardial stunning and reperfusion injury, the LV ejection fraction (LVEF), a powerful prognostic parameter improves steeply during the first week after MI [25, 26].…”

“…During the last two decades, the clinical indications of rHuEPO have been expanded to anemia in diverse clinical categories, including anemic patients with chronic kidney disease [10]. Beyond the conventional effect of secreted erythropoietin from the kidney in response to hypoxic stimuli, EPO was recently identified as a pleiotropic and organ-protective cytokine, mediating repair and regeneration via anti-apoptosis, anti-inflammation, anti-oxidation, pro-angiogenesis and re-endothelialization, vascular-protectant, mobilization of endothelial progenitor cells, and recruitment of stem cells into the zone of damage [10–13]. Apart from traditional erythropoietic effects, the pleiotropic organ-protective effects of erythropoietin (EPO) make it a frontline cardioprotective candidate[11].…”

Development of novel drug delivery systems using phage display technology for clinical application of protein drugs

“…Indeed, attempts are currently under way to develop a wide variety of therapeutic proteins for treating conditions such as cancer, infectious diseases, and autoimmune disorders. 4–8) …”