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How to administrate erythropoietin, intravenous or subcutaneous?
Simonetta Costa1, Costantino Romagnoli, Antonio Alberto Zuppa
1Division of Neonatology, Department of Pediatrics, Catholic University of Sacred Heart, Rome, Italy. simocosta@yahoo.it
Insights
Continuous intravenous erythropoietin administration in preterm infants showed an erythropoietic effect comparable to subcutaneous dosing. This intravenous (IV) method is a viable alternative for preterm infants requiring erythropoietin therapy.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Pharmacology
Background:
- Preterm infants often require interventions to manage anemia.
- Erythropoietin therapy is used to stimulate red blood cell production.
- Subcutaneous (SC) administration is a common route for erythropoietin.
Purpose of the Study:
- To evaluate if continuous intravenous (IV) erythropoietin infusion is non-inferior to SC administration in preterm infants.
- To assess the erythropoietic effect of IV versus SC erythropoietin.
- To compare transfusion needs and hematologic parameters between the two administration routes.
Main Methods:
- Randomized controlled trial involving preterm infants (≤1500g, ≤32 weeks gestational age).
- Infants received erythropoietin (300 units/kg, 3x/week) either SC or via continuous IV infusion.
- Treatment continued until 36 weeks postmenstrual age or discharge.
Main Results:
- 100 infants were randomized (50 per group).
- No significant differences in transfusion incidence, phlebotomy losses, reticulocyte counts, transferrin saturation, or ferritin levels were observed.
- No differences in the incidence of side effects between the IV and SC groups.
Conclusions:
- Continuous intravenous administration of erythropoietin is not inferior to subcutaneous dosing in preterm infants.
- IV erythropoietin offers a comparable erythropoietic effect to SC administration.
- This study supports the use of continuous IV erythropoietin as an alternative therapeutic option.
Aim:
To determine whether adding recombinant erythropoietin to the intravenous (IV) solution and administering it as a 24-h continuous infusion would result in an erythropoietic effect not inferior to that seen with subcutaneous (SC) administration.
Methods:
Infants weighing ≤1500 grams and ≤32 weeks of gestational age were randomly assigned at 72 h of life to receive erythropoietin (300 units/kg, 3 times a week until 36 complete weeks of postmenstrual age or discharge), either subcutaneously [erythropoietin subcutaneous (ESC) group] or added to IV fluids [erythropoietin intravenous (EIV) group].
Results:
One hundred infants were randomized (50 in the EIV group and 50 in the ESC group). The incidence of transfusions was comparable in the two groups, similar in baseline characteristics and haematologic values at study entry. Phlebotomy losses did not differ between groups, and at the end of the study, there were no differences in reticulocyte counts, transferrin saturation and ferritin. No differences in the incidence of side effects were observed.
Conclusions:
In preterm infants, continuous intravenous administration of erythropoietin was not inferior to SC dosing.
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