Effect of switching from subcutaneous to intravenous administration of epoetin-α in haemodialysis patients: Results from a Swedish multicentre survey

Abstract

Objective In 2002, many haemodialysis patients were switched from subcutaneous (s.c.) to intravenous (i.v.) administration of epoetin-α following reports of antibody formation and development of pure red-cell aplasia in patients treated via the s.c. route. We evaluated the possible effect of this change in the route of administration on haemoglobin (Hb) levels and epoetin-α requirements. Material and methods This retrospective survey involved 223 haemodialysis patients from 25 Swedish centres. Variables were recorded before and after a mean period of 213 days (range 89–297 days) after the change in the route of administration. Results The mean epoetin-α do had to be increased from 159±104 to 185±122 U/kg/week (p<0.0001) to maintain a constant Hb level (121±12 vs 120±11 g/l). Plasma ferritin, albumin, C-reactive protein, iron, iron transferrin saturation and body mass index remained constant. The relative increase in epoetin-α dose was negatively correlated with the s.c. dose prior to the switch (R=–0.3; p<0.0001), with the most pronounced dose increases occurring in patients who received a low s.c. dose. Conclusions A switch from s.c. to i.v. administration of epoetin-α in haemodialysis patients was accompanied by an increase in the mean dose requirement of 15%. This increase may be less pronounced in patients receiving high s.c. doses prior to the switch.

• Dose requirement
• epoetin-α
• erythropoietin
• haemodialysis
• renal anaemia