J Med Assoc Thai 2007; 90 (4):636

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12-Week Clinical Effects of Erythropoietin EspogenTM in End Stage Renal Patients undergoing Hemodialysis
Thitiarchakul S Mail, Tasanarong A

Background: Anemia is one of most common complications in end stage renal disease (ESRD) patients. Erythropoietin has been recommended for treatment of anemia in these patients.
Objectives: To evaluate the clinical efficacy, safety and usefulness of newly imported erythropoietin, called EspogenTM, usage in ESRD undergoing hemodialysis.
Material and Method: An open, non-comparative, prospective study of administered EspogenTM was conducted in 30 ESRD patients undergoing hemodialysis for a 12 week period. Eligible criteria included hemoglobin of less than 8 g%, hematocrit of less than 25% for at least three consecutive months with a serum ferritin of more than 100 ng%. Initial dose of drug was 150 units/kg/week subcutaneously, two or three times a week and dosage was adjusted to maintain the Hb at 10-12 g%.
Results: In 28 patients, hemoglobin and hematocrit were increased significantly from 7.1±1.14 g/dl and 22.1±3.24% at baseline to 10.1±1.49 g/dl and 31.7±4.01% at the end of the study period respectively (p<0.05). Mean weekly of EspogenTM dosage was 8390±2452.7 IU/week, which was 152.1 IU/kg/week. Some patients could reduce the dose at week 10. Reticulocyte increased significantly from 0.69±0.58% at baseline to highest value, 1.41±0.74 at 2 week and 1.30±0.66 at the end of the present study. Serum vitamin B12, serum folate, and red blood cell folate were not significantly changed. However, serum ferritin decreased significantly from 840.6±948.95 to 582.7±990.70 ng/ml (p<0.05). General condition including SF-36 score and tiredness were improved. There were no significant adverse events except mean arterial blood pressure of pre dialysis value which was statistically significant increased at the end of the present study (from 101.0±17.65 at week 0 and 110.4±16.8 mmHg at week 12, p = 0.0223).
Conclusion: This clinical study showed that EspogenTM has proven effective and safe for treatment of anemia in hemodialysis patients. No serious adverse events occurred during the study period.

Keywords:Erythropoietin, EspogenTM, Anemia, Hemodialysis, End stage renal failure


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