In Which Neonates Does Early Recombinant Human Erythropoietin Treatment Prevent Anemia of Prematurity? Results of a Randomized, Controlled Study

Soubasi, Vasiliki; Kremenopoulos, George; Diamandi, Elisabeth; Tsantali, Chaido; Tsakiris, Dimitrios

doi:10.1203/00006450-199311000-00022

Cited by 71 publications

(33 citation statements)

References 2 publications

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“…Ela é um processo autolimitado, e sua intensidade aumenta quanto mais prematuro for o RN, tornando-se, assim, menos fisiológica 7 . Os mecanismos pelos quais a anemia da prematuridade se desenvolve são coleta excessiva de sangue para exames laboratoriais, crescimento somático das crianças, menor vida média dos eritrócitos neonatais, pequena transfusão placento-fetal ao nascimento e cessação da liberação de eritropoetina (EPO) 6,[8][9][10][11] . Vários estudos encontraram, neste período, concentrações séricas de EPO inapropriadamente baixas 5,7,12 .…”

Section: Introductionunclassified

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O efeito da eritropoetina humana recombinante no tratamento da anemia da prematuridade

Rocha

Benjamin²,

Procianoy³

2001

J. Pediatr. (Rio J.)

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Objective: to assess the efficacy of erythropoietin in the prevention and treatment of anemia of prematurity, correlating the use of this drug with weight gain, length, and head circumference and comparing two administration schemes of he same weekly dose: daily use and twice a week.Methods: the study comprised 42 premature newborns with gestational age up to 33 weeks, birthweight up to 1550 g, and postnatal age between 10 and 35 days. The newborns were randomized into three groups: patients in group 1 received seven daily doses of 100 U/kg erythropoietin per week; patients in group 2 received two 350 U/kg erythropoietin doses per week; and patients in group 3 did not receive the drug. Hematologic measurements, blood transfusion requirements, and growth rates were followed during therapy.Results: cases and controls did not differ with respect to weight, length, head circumference, and total time of hospital stay. At the end of the study, no significant difference was observed in the platelet count measurement means, white blood cell count, and ferritin levels in the three groups. However, the final hematocrit and hemoglobin values of patients who did not receive erythropoietin were significantly lower than those of patients who received the drug. The absolute reticulocyte count mean was significantly higher in patients who received erythropoietin after two weeks of treatment when compared with those patients who did not receive the drug. Patients in group 1 e 2 received fewer excessive transfusions (2 or more) than patients in group 3. The administration of 700 U/kg/week erythropoietin significantly reduced the number of excessive blood transfusions. There is no significant difference in blood transfusion volume between patients who received erythropoietin on a daily basis and those who received the drug twice weekly.Conclusions: the use of erythropoietin did not influence weight gain and growth. The administration of 700 U/kg/week erythropoietin in premature infants with gestational age up to 33 weeks and birthweight up to 1550 g stimulates erythropoiesis and significantly reduces excessive blood transfusion requirements. Erythropoietin showed to be a safe and well tolerated medication, with no short-term side effects in the study population.J Pediatr (Rio J) 2001; 77 (2): 75-83: erythropoietin, anemia of prematurity, transfusion, premature. ResumoObjetivos: a proposta do presente estudo foi avaliar a eficácia da eritropoetina na prevenção e tratamento da anemia da prematuridade, correlacionar o uso desta medicação com o ganho de peso, comprimento e perímetro cefálico dos pacientes. Foi realizada também uma comparação entre o uso de eritropoetina diariamente e o uso duas vezes por semana, na mesma dose semanal.Métodos: ensaio clínico que avaliou 42 recém-nascidos prematuros, com até 33 semanas de idade gestacional, peso de nascimento até 1550g e idade pós-natal entre 10 e 35 dias de vida. Os recém-nascidos foram randomizados em três grupos. Os pacientes do grupo 1 receberam 7 doses diárias, de 100U/kg c...

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Section: Introductionunclassified

“…No ano seguinte dois ensaios clínicos randomizados não mostraram melhora na Hb dos pacientes tratados com EPO 3,23 . Em 1993 e 1995, Soubasi e colaboradores mostraram que há sucesso com o uso de EPO na anemia da prematuridade 10,23 . Outros estudos demonstraram menor necessidade de TSs associadas ao tratamento com EPO 24,25 .…”

Section: Introductionunclassified

O efeito da eritropoetina humana recombinante no tratamento da anemia da prematuridade

Rocha

Benjamin²,

Procianoy³

2001

J. Pediatr. (Rio J.)

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show abstract

“…General characteristics of the 12 acceptable, relevant, studies [6][7][8][9][10][11][12][13][14][15][16][17] are given in Table 1, listed in chronological order of publication. The 12 studies involved a total of 1090 VLBW neonates; 561 rEpo and 529 placebo recipients.…”

Section: Resultsmentioning

confidence: 99%

“…The data regarding ''late'' transfusions could be analyzed for nine studies [6][7][8][12][13][14][15][16][17] (Q ¼ 10.81, p ¼ 0.289). The OR for receiving a ''late'' transfusion if rEpo was begun in the first week of life was 0.56 (95% CI: 0.37 to 0.83, p ¼ 0.036.…”

Section: Resultsmentioning

confidence: 99%

“…Studies that utilized a randomized, placebo-controlled and double-masked design, where rEpo and placebo treatments were begun in the first week of life, were selected. [6][7][8][9][10][11][12][13][14] Studies that did not include the use of a placebo in their design, but described a procedure to maintain appropriate masking, were also considered eligible. [15][16][17] Studies were included in the meta-analysis if the authors reported at least one of the following outcomes: proportion of neonates transfused, mean number of transfusions per patient, and mean volume of erythrocyte transfusion for both rEpo and control groups.…”

Section: Materials and Methods Study Identification And Assessmentmentioning

confidence: 99%

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Effect of Beginning Recombinant Erythropoietin Treatment Within the First Week of Life, Among Very-Low-Birth-Weight Neonates, on “Early” and “Late” Erythrocyte Transfusions: A Meta-Analysis

et al. 2003

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Epoetin Alfa Therapy in Infants Awaiting Heart Transplantation

Shaddy

Bullock²,

Tani³

et al. 1995

Arch Pediatr Adolesc Med

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In Which Neonates Does Early Recombinant Human Erythropoietin Treatment Prevent Anemia of Prematurity? Results of a Randomized, Controlled Study

Cited by 71 publications

References 2 publications

O efeito da eritropoetina humana recombinante no tratamento da anemia da prematuridade

O efeito da eritropoetina humana recombinante no tratamento da anemia da prematuridade

Effect of Beginning Recombinant Erythropoietin Treatment Within the First Week of Life, Among Very-Low-Birth-Weight Neonates, on “Early” and “Late” Erythrocyte Transfusions: A Meta-Analysis

Epoetin Alfa Therapy in Infants Awaiting Heart Transplantation

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