The practical aspects of therapy with rHuEPO

A number of multicenter US trials provide extensive experience with the benefits of recombinant human erythropoietin. The dose-response relationships obtained using epoetin-beta are presented. Recommendations with respect to optimal dose requirements as derived from these trials are reviewed. How low-dose therapy affects hematocrit as well as its ability to decrease transfusion requirements is discussed. Low-dose therapy is also examined in the context of a possible decrease in adverse experiences. Dosing regimens, including once weekly vs. three times weekly i.v. therapy, is explored. Preliminary information on the efficacy of subcutaneous injections is discussed in light of the pharmacokinetic data currently available. The importance of adequate iron stores is emphasized at all doses. Regardless of the route of administration, the level of iron stores is critical.