Experience with low dose intravenous and subcutaneous administration of recombinant human erythropoietin

Twelve stable haemodialysis patients were divided into two groups and given recombinant human erythropoietin (r-HuEPO) for 14 weeks either intravenously (i.v.) or subcutaneously (s.c.). Dosage was 25 units/kg either thrice (i.v.) or twice (s.c.) per week for 7 weeks, and then 50 units/kg for a further 7 weeks. Response to s.c. therapy was comparable to i.v. despite a 33% lower weekly dosage, and was significant at both 7 (i.v.: 1.1 +/- 0.3, mean +/- SEM, p = 0.02; s.c.: 0.8 +/- 0.3 g/dl, p = 0.03) and 14 weeks (i.v.: 2.8 +/- 0.5, p = 0.003; s.c.: 2.6 +/- 0.6 g/dl, p = 0.009). A correlation was observed between response to r-HuEPO and initial ferritin levels (r = 0.63, p = 0.04). One patient required an increase in antihypertensive medication and there was one arteriovenous fistula thrombosis. Results suggest that overall s.c. therapy is as effective as i.v. therapy, and that a good response with few side effects can be obtained using relatively low doses of r-HuEPO.