Subcutaneous Low-Dose Epoetin Beta for the Avoidance of Transfusion in Patients Scheduled for Elective Surgery Not Eligible for Autologous Blood Donation

Abstract

This randomized, multicentre, parallel-group study assessed the efficacy of epoetin beta in reducing the transfusion frequency in patients ineligible for autologous blood donation prior to surgery. The patients (n = 194) received either epoetin beta (125 or 250 IU/kg, once weekly) or no therapy for 3–4 weeks before surgery. The pre-operation haemoglobin levels were markedly increased in the epoetin beta groups (125 IU/kg: +1.1 g/dl; 250 IU/kg: +1.6 g/dl), but not in the control group. The transfusion frequency was significantly reduced in both epoetin groups as compared with the control group (p = 0.046). Epoetin beta was well tolerated, and no serious adverse events were observed. Low-dose administration of epoetin beta before elective surgery reduces the transfusion frequencies in patients not eligible for autologous blood donation.

Surgical Management of Leiomyomas for Fertility or Uterine Preservation

“…21 A randomized study showed that use of epoetin, a recombinant form of erythropoietin, 250 international units/kg (approximately 15,000 units), per week for 3 weeks before elective surgery increased hemoglobin concentrations by 1.6 g/dL and significantly reduced transfusion rates when compared with control patients. 22 However, epoetin is more expensive than iron infusions. Gonadotropin-releasing hormone agonist may be used preoperatively to stop abnormal bleeding with a resultant increase of hemoglobin concentration.…”

Uterine myomas: management

“…Erythropoietin alfa and epoetin, recombinant forms of erythropoietin, commonly are used to increase preoperative hemoglobin concentrations in cardiac, orthopedic, and neurologic surgery. A randomized study showed that use of epoetin (250 IU/kg per wk, approximately 15,000 IU) for 3 weeks before elective surgery was shown to increase the hemoglobin concentration by 1.6 g/dL and significantly reduce transfusion rates when compared with the case of controls (60). No side effects were experienced.…”

Recombinant erythropoietin in clinical practice

“…69 70 Furthermore, a recent study has demonstrated that in patients who were not eligible for autologous donation, a low dose of RHuEPO (150 IU/kg/week) given 3-4 weeks before surgery reduced the blood transfusion requirement by nearly 50%. 71 Anaemia associated with HIV infection Up to two thirds of patients suffering from AIDS have anaemia, particularly those who are receiving zidovudine therapy. Treatment with RHuEPO, given either as a weekly dose (24 000-48 000 U) or as a thrice weekly administration (100-200 U/kg), corrects anaemia, improves the patient's quality of life when baseline serum erythropoietin is <500 mU/ml, and improves survival.…”