Recombinant erythropoietin in clinical practice

Ng, Tien M. H.; Marx, Grace E; Littlewood, Timothy; Macdougall, Iain C.

doi:10.1136/pmj.79.933.367

Cited by 92 publications

(86 citation statements)

References 92 publications

(58 reference statements)

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“…The introduction of the recombinant form of human erythropoietin ushered in a new era in the management of anemia in end stage renal disease and later on in other nondialysis expanded indications [18,23]. Epoetin alfa and beta are recombinant human erythropoietins.…”

Section: Recombinant Human and Other Forms Of Erythropoietinmentioning

confidence: 99%

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Manolis¹,

Tzeis²,

Triantafyllou³

et al. 2005

CDTCHD

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Erythropoietin is a hypoxia-induced hormone that is a major regulator of normal erythropoiesis. Over the last decade, the production of recombinant human erythropoietin has revolutionized the treatment of anemia associated with chronic renal failure, and has led to a greater understanding of anemia pathophysiology and to the elucidation of the interactions of erythropoietin, iron, and erythropoiesis. Anemia has been shown to be independently associated with increased mortality and disease progression. Potential survival benefits associated with correction of anemia have expanded considerably the indications of erythropoietin use in various patient populations and are leading to consideration of earlier, more aggressive treatment of mild to moderate anemia. The results of such treatment are promising in a variety of new clinical settings, including anemia associated with congestive heart failure. Furthermore, the erythropoietin receptor is widely distributed in the cardiovascular system, including endothelial cells, smooth muscle cells and cardiomyocytes and preclinical studies have established erythropoietin to be a pleiotropic cytokine with anti-apoptotic activity and tissue-protective actions in the cardiovascular system, beyond correction of hemoglobin levels. Despite some potential adverse effects, such as hypertension, and the occurrence of erythropoietin resistance, early studies in heart failure patients with anemia suggest that erythropoietin therapy is safe and effective in reducing left ventricular hypertrophy, enhancing exercise performance and increasing ejection fraction.Anemia is found in about one-third of all cases of congestive heart failure (CHF). The most likely common cause is chronic renal insufficiency, which is present in about half of all CHF cases. However, anemia can occur in CHF without renal insufficiency and is likely to be due to excessive cytokine production. The anemia itself can worsen cardiac function, both because it causes cardiac stress through tachycardia and increased stroke volume, and because it can cause a reduced renal blood flow and fluid retention, adding further stress to the heart. Long-standing anemia of any cause can cause left ventricular hypertrophy, which can lead to cardiac cell death through apoptosis and worsen CHF. Therefore, a vicious circle, cardio-renal anemia syndrome, is set up wherein CHF causes anemia, and the anemia causes more CHF and both damage the kidneys worsening the anemia and the CHF further and increasing mortality. There is now evidence that early correction of the CHF anemia with subcutaneous erythropoietin and intravenous iron improves shortness of breath and fatigue, cardiac function, renal function and exercise capacity, reducing the need for hospitalization and improving quality of life.In the present review we discuss the data on current clinical use of erythropoietin in cardiovascular disease, with the main focus on the treatment of congestive heart failure, and summarize the advances and progress made in the understanding...

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Section: Recombinant Human and Other Forms Of Erythropoietinmentioning

confidence: 99%

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Manolis¹,

Tzeis²,

Triantafyllou³

et al. 2005

CDTCHD

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“…Recombinant human EPO (rhEPO) is an effective treatment modality of anemia associated with chronic renal failure (5) and is used in the eu and the united States for the treatment of anemia in cancer patients who have received myelosuppressive chemotherapy or radiotherapy. anemia associated with cancer and cancer therapy is one of the independent prognostic factors in the treatment of malignant diseases.…”

Section: Introductionmentioning

confidence: 99%

Effect of erythropoietin on human tumor growth in xenograft models

Kataoka¹,

Moriya²,

Moriguchi³

et al. 2009

Mol Med Rep

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Abstract. recombinant human erythropoietin (rhePo) has been used in the eu and the united States for the treatment of anemia in cancer patients after myelosuppressive chemotherapy or radiotherapy. However, several conflicting results have been reported concerning the detrimental effect of rhEPO on survival benefit in cancer patients. In experimental studies, contradictory results were also reported in in vitro tumor cell proliferation studies and in vivo tumor growth studies using tumor cells expressing EPO-receptor (EPO-R). Therefore, we tried to clarify the effect of epoetin β, a product of rhEPO, on tumor growth in xenograft models using five ePo-r-positive human cancer cell lines, namely the McF7 breast, 786-O renal, SCH gastric, A549 lung and SK-OV-3 ovarian cancer cell lines. epoetin β was administered once a week for 3 weeks at doses of 1,000, 3,000 and 10,000 IU/kg in accordance with the clinical administration schedule and dosages. As a result, no enhancement of tumor growth from the administration of epoetin β was observed in any of the xenograft models throughout the experiment duration. The effect of epoetin β on the antitumor activity of bevacizumab, an anti-angiogenic agent, was additionally examined using A549 and MCF7 xenograft models, since rhEPO reportedly stimulates tumor neovascularization. epoetin β showed no significant effect on the antitumor activity of bevacizumab in either xenograft model. These findings suggest that epoetin β is not involved in in vivo tumor growth promotion.

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“…Anemia defined, as an inadequate number of hemoglobin containing red blood cells, is a widely prevalent complication among cancer patients and varies by type of neoplasia and cytotatic treatment [1][2][3] . Apart from the physical symptoms and diminished quality of life 4 patients with anemia experience, there is some evidence that anemia; with the consequence of increased tumor hypoxia might result in a poorer response to radiotherapy [5][6][7][8][9] or chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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IJPSR

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Recombinant erythropoietin in clinical practice

Cited by 92 publications

References 92 publications

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Erythropoietin in Heart Failure and Other Cardiovascular Diseases: Hematopoietic and Pleiotropic Effects

Effect of erythropoietin on human tumor growth in xenograft models

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