Efficacy of Recombinant Human Erythropoietin Administered Subcutaneously to Capd Patients Once Weekly

1996 ◽  
Vol 16 (6) ◽  
pp. 594-598 ◽  
Author(s):  
Jens J. Frifelt ◽  
Erling Tvedegaard ◽  
Kirsten Bruun ◽  
Gudrun Steffensen ◽  
Christina Cintin ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Blood Levels ◽  
Treatment Schedule ◽  
Weekly Dose ◽  
Dosing Regimen ◽  
University Hospitals ◽  
Human Erythropoietin ◽  
Group A ◽  
Group B ◽  
Study Setting

Objective The purpose of the present study was to compare the dosage requirements of recombinant human erythropoietin (rHuEPO) administered subcutaneously (SC) either one or three times weekly. Design A randomized, prospective study. .Setting: The patients were recruited from two university hospitals and five county hospitals. Patients Thirty-three anemic patients on continuous ambulatory peritoneal dialysis (CAPD) treatment for endstage renal failure completed the study. Interventions Initially, all were treated with rHuEPOSC three times a week until hemoglobin blood levels (Hb) remained constant between 105 and 121 g/L for three months. Following randomization, 17 patients continued the same treatment schedule (group A), while 16 patients received the same dose, but administered only once weekly for three months (group B). Main Outcome Measures The Hb levels and rHuEPO doses at the start and at the end of the three-month study period. Results In group A the median Hb at randomization was 118 g/L (109 -119) (25 -75 percentiles) and, after three months, was 113 g/L (106 -119) (p = 0.13), while in group B the median Hb was 114g/L (108–119) and 114 g/L (106 -120), respectively (p = 0.50). In group A the weekly dose of rHuEPO remained virtually unchanged during the study period, 65 (55 -86) and 66.3 (55 -95) U/kg/week, respectively, while in group B it was increased from 60.2 (46–88) to 77 (60 90) U/kg/week. The 22% increase (p = 0.03) took place during the last two weeks. Conclusions Our findings indicate that a once-weekly SC dosing regimen of rHuEPO in anemic CAPD patients was equally effective in maintaining a stable hemoglobin level as a thrice-weekly dosing regimen.

scholarly journals Androgen versus erythropoietin for the treatment of anemia in hemodialyzed patients: a prospective study.

1996 ◽  
Vol 7 (1) ◽  
pp. 140-144
Author(s):  
J L Teruel ◽  
R Marcen ◽  
J Navarro-Antolin ◽  
A Aguilera ◽  
G Fernandez-Juarez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Recombinant Human Erythropoietin ◽  
Dry Weight ◽  
Pressure Control ◽  
Therapeutic Approaches ◽  
Human Erythropoietin ◽  
Group A ◽  
Male Patients ◽  
Group B ◽  
A Prospective Study

According to this facility's protocol for the treatment of anemia in hemodialyzed patients, androgens were administered to male patients aged over 50 yr and recombinant human erythropoietin was administered to male patients below 50 yr of age and to female patients. In the study presented here, both therapeutic approaches have been prospectively analyzed. Patients were divided into two groups. Group A was composed of 18 patients, aged 62 +/- 12 yr, treated with nandrolone decanoate (200 mg/wk im) for 6 months; Group B was composed of 22 patients (6 men, 16 women) aged 47 +/- 15 yr, treated with subcutaneous recombinant human erythropoietin (initial dose, 6000 IU/wk) for 6 months. The increases of hemoglobin were similar in both groups; Group A, from 7.3 +/- 0.8 to 10.8 +/- 1.7 g/dL (P < 0.001), and Group B, from 7 +/- 0.6 to 10.4 +/- 1 g/dL (P < 0.001). In Group A, increases of triglycerides (159 +/- 71 versus 267 +/- 153 mg/dL, P < 0.001), serum albumin (3.9 +/- 0.3 versus 4.2 +/- 0.3 g/dL, P < 0.05), and dry weight (62.1 +/- 9.8 versus 64.9 +/- 10.1 kg, P < 0.001) were observed, which remained unmodified in Group B. Blood pressure control worsened in one patient (6%) from Group A, and in ten patients (45%) from Group B (P < 0.05). In conclusion, androgens produced an improvement in anemia in selected patients, similar to that achieved by use of recombinant human erythropoietin but at a lower cost. Androgens also have an appreciable anabolic effect and did not increase the blood pressure.

scholarly journals Clinical effectiveness of 3 days preoperative treatment with recombinant human erythropoietin in total knee arthroplasty surgery: a clinical trial

QJM ◽  
2019 ◽  
Vol 113 (4) ◽  
pp. 245-252
Author(s):  
S -L Cao ◽  
Y Ren ◽  
Z Li ◽  
J Lin ◽  
X -S Weng ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Recombinant Human Erythropoietin ◽  
Iron Supplement ◽  
Human Erythropoietin ◽  
Group A ◽  
Total Knee ◽  
Group B

Abstract Aims The purpose of study is to evaluate the effect and complication of preoperative short-term daily recombinant human erythropoietin (rhEPO) treatment for blood-saving in patients undergoing unilateral primary total knee arthroplasty (TKA). Methods This three-arm randomized clinical trial compared three different rhEPO-based treatment protocols for unilateral primary TKA. Group A: application of daily doses of rhEPO combined with iron supplement starting 3 days before surgery; Group B: application of daily doses of rhEPO combined with iron supplement starting the day of surgery; Group C: iron supplement alone. Perioperative hemoglobin (Hb) level gaps, total perioperative blood loss, reticulocyte levels and treatment-related complications were studied. Results A total of 102 patients were included (35, 35 and 32 patients in Groups A, B and C, respectively). Total blood loss (TBL) in Groups A, B and C was 490.84, 806.76 and 924.21 ml, respectively. Patients in Group A had a significant lower TBL than Groups B and C (A vs. B: P = 0.010; A vs. C: P &lt; 0.001). There was no difference as for TBL between Groups B and C (P = 0.377). Group A patients had significant smaller Hb decline than Group C on the third and fifth postoperative day (P = 0.049, P = 0.037), as well as than Group B on the fifth postoperative day (P = 0.048). There was no difference as for Hb decline between Groups B and C. No difference was shown in levels of inflammatory biomarkers or blood-saving protocol-related complications among three groups. Conclusions Daily dose of rhEPO combined with iron supplement administered 3 days before TKA procedures could significantly decrease perioperative blood loss and improve postoperative Hb levels, without significantly elevating risks of complication, when compared with admission of rhEPO on the day of surgery and iron supplement alone. Preoperative daily rhEPO treatment could be a more effective blood-saving protocol in TKA procedures.

Recombinant Human Erythropoietin Stimulates Erythropoiesis and Reduces Erythrocyte Transfusions in Very Low Birth Weight Preterm Infants

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 1-8
Author(s):  
Kevin M. Shannon ◽  
Julian F. Keith ◽  
William C. Mentzer ◽  
Richard A. Ehrenkranz ◽  
Mark S. Brown ◽  
...  
Keyword(s):  
Placebo Group ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Recombinant Human Erythropoietin ◽  
Very Low Birth Weight ◽  
Group Versus ◽  
Weekly Dose ◽  
Human Erythropoietin ◽  
Transfusion Requirements

Design and methods. We hypothesized that treatment with recombinant human erythropoietin (r-HuEPO) would stimulate erythropoiesis and would thereby reduce the need for erythrocyte transfusions in preterm infants. We treated 157 preterm infants born at 26.9 ± 1.6 weeks of gestation who weighed 924 ± 183 g at birth with either subcutaneous r-HuEPO (100 U/kg/d, 5 days per week) or placebo for 6 weeks in a randomized, double-blind, controlled clinical trial. All patients received oral iron and were managed according to uniform conservative transfusion guidelines. Results. Treatment with r-HuEPO was associated with fewer erythrocyte transfusions (1.1 ± 1.5 per infant in the r-HuEPO group versus 1.6 ± 1.7 per infant in the placebo group; P = .046) and with a reduction in the volume of packed erythrocytes transfused (16.5 ± 23.0 mL versus 23.9 ± 25.7 mL per infant; P = .023). Overall, 43% of the infants in the r-HuEPO group and 31% of placebo-treated infants were transfusion-free during the study (P = .18). The volume of blood removed for laboratory tests and the need for respiratory support at the start of treatment had major effects on transfusion requirements independent of r-HuEPO. Reticulocyte counts were higher during treatment in the r-HuEPO group (P = .0001), and r-HuEPO-treated infants had higher hematocrit values at the end of the study (32% versus 27.3% in the placebo group; P = .0001). We found no differences in the incidence of major complications of prematurity between the treatment groups. Conclusion. We conclude that treatment with r-HuEPO at a weekly dose of 500 U/kg stimulates erythropoiesis, moderates the course of anemia, is associated with a reduction in erythrocyte transfusions, and appears safe in very low birth weight preterm infants who are receiving iron supplements. Conservative transfusion criteria, minimization of phlebotomy losses, and treatment with r-HuEPO are complementary strategies to reduce erythrocyte transfusions in these infants.

scholarly journals Diabetic Retinopathy Treated with Laser Photocoagulation and the Indirect Effect on Glycaemic Control

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Anna Praidou ◽  
Sofia Androudi ◽  
Periklis Brazitikos ◽  
George Karakiulakis ◽  
Eleni Papakonstantinou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glycaemic Control ◽  
Laser Treatment ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Previous Treatment ◽  
Blood Levels ◽  
Patients With Diabetes ◽  
Group A ◽  
Group B

Purpose. To identify any possible relation between glycaemic control and previous laser photocoagulation for diabetic retinopathy.Methods. Seventy-two patients with diabetes were included in the study and were separated into 2 groups according to previous treatment (group A) or not (group B) with argon laser photocoagulation. Glycaemic control was estimated by measuring blood levels of HbA1c in four consecutive measurements.Results. Blood levels of HbA1c in group A were significantly lower 3, 6, and 12 months after laser treatment as compared to blood levels of HbA1c before laser treatment (7.1±0.4% versus7.6±0.9%,7.2±0.2% versus7.6±0.9%, and7.1±0.2% versus7.6±0.9%, resp., allP<0.05). Blood levels of HbA1c in group B did not differ significantly in four consecutive measurements.Conclusion. Our results suggest that we should anticipate a better glycaemic control in cases of patients with diabetes previously treated with laser photocoagulation.

scholarly journals Clinical efficacy of different dosage forms containing vitamin D: design and study outcomes of a randomized, comparative clinical trial

2020 ◽  
Vol 7 (3) ◽  
pp. 176
Author(s):  
Nidhi Sapkal ◽  
Gaurav Chhaya ◽  
Milan Satya ◽  
Dhara Shah
Keyword(s):  
Vitamin D ◽  
Clinical Efficacy ◽  
Dosage Forms ◽  
Oral Solution ◽  
Blood Levels ◽  
Open Label ◽  
Soft Gelatin Capsules ◽  
25 Hydroxy Vitamin D ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Different dosage forms of vitamin D like tablets, soft gelatin capsules, oral granules, powders, solutions and thin films are available. The objective of the present study was to evaluate and compare the clinical efficacy of three different dosage forms of vitamin D3 namely, orally disintegrating strips, oral granules and oral solution.</p><p class="abstract"><strong>Methods:</strong> An open label, single centre, prospective, randomized, parallel group, comparative study was conducted for a period of 4 months. The study participants were divided into three groups (A, B, C) and received the respective treatments (orally disintegrating strips, n=20; granules, n=20; oral nano solution, n=10) for the study period. The estimation of blood levels of 25-hydroxy vitamin D [25(OH)D<sub>3</sub>] in all the subjects at day 0, 60 and 120 was carried out.</p><p class="abstract"><strong>Results:</strong> The normalization level of 25(OH)D<sub>3 </sub>achieved by the subjects in group A, group B and group C was 100%, 83.3% and 90% respectively after 90 days. Comparison of 25(OH)D<sub>3 </sub>level in all three groups showed significant increase at day 60. The levels were maintained at day 90 and 120 even after drastic reduction in dosage in Group A and group C. On day 120, the dose reduction was in the order of group A&gt;group C&gt;group B.</p><p class="abstract"><strong>Conclusions: </strong>All the three formulations showed increase in the level of 25(OH)D<sub>3. </sub>It can be concluded that oral disintegrating strips of 25(OH)D<sub>3</sub> are clinically more efficient than other conventional dosage forms.</p>

Effects of spaceflight on rat erythroid parameters

1996 ◽  
Vol 81 (1) ◽  
pp. 117-122 ◽  
Author(s):  
Z. Allebban ◽  
L. A. Gibson ◽  
R. D. Lange ◽  
T. L. Jago ◽  
K. M. Strickland ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Life Sciences ◽  
Lower Number ◽  
Ground Control ◽  
Colony Forming Unit ◽  
Human Erythropoietin ◽  
Group A ◽  
Group B ◽  
First Time ◽  
Group D

Hematologic studies were performed on 21 ground control rats and 21 rats flown during the Spacelab Life Sciences-2 14-day mission. Group A (n = 5) was used to collect blood in flight and 9 days postflight, group B (n = 5) was injected with recombinant human erythropoietin (rhEpo), group C (n = 5) received saline as a control, and group D (n = 6) was killed in flight and tissues were collected. Results indicated no significant changes in peripheral blood erythroid elements between flight and ground control rats. The nonadherent bone marrow on flight day 13 showed a lower number of recombinant rat interleukin-3 (rrIL-3)-responsive and rrIL-3 + rhEpo-responsive blast-forming unit erythroid (BFU-e) colonies in flight rats compared with ground control rats. On landing day, a slight increase in the number of rhEpo + rrIL-3-responsive BFU-e colonies of flight animals compared with ground control rats was evident. Nine days postflight, bone marrow from flight rats stimulated with rhEpo alone or with rhEpo + rrIL-3 showed an increase in the number of colony-forming unit erythroid colonies and a decrease in BFU-e colonies compared with ground control rats. This is the first time that animals were injected with rhEpo and subsequently blood and tissues were collected during the spaceflight to study the regulation of erythropoiesis in microgravity.

Intraperitoneal Administration of Recombinant Human Erythropoietin

1992 ◽  
Vol 12 (4) ◽  
pp. 378-383 ◽  
Author(s):  
Leon A.M. Frenken ◽  
Dirk G. Struijk ◽  
Peter J.W. Coppens ◽  
Roland G.W.L. Tiggeler ◽  
Raymond T. Krediet ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Intraperitoneal Administration ◽  
Subcutaneous Administration ◽  
Hemoglobin Concentration ◽  
Treated Group ◽  
Efficacy And Safety ◽  
University Hospitals ◽  
Safe Alternative ◽  
Human Erythropoietin ◽  
Dialysis Solution

Objective To determine the efficacy and safety of intraperitoneal administration of recombinant human erythropoietin (rHuEPO) in continuous ambulatory peritoneal dialysis (CAPD) patients compared to subcutaneous rHuEPO. Design Prospective analysis of an open, nonrandomized investigation. Setting Outpatient CAPD clinics in two university hospitals. Patients Nine adult CAPD patients receiving rHuEPO intraperitoneally and 8 patients receiving rHuEPO sub-cutaneously. Intervention One hundred units of rHuEPO per kilogram of body weight were administered three times a week for 8 weeks or until the target hematocrit of 35% was reached. Thereafter, dosages of rHuEPO were adjusted for response. Intraperitoneal rHuEPO was administered in 1 L of dialysis solution during the night. Measurements Efficacy was assessed by measuring the increase in hemoglobin. Tolerance was assessed by monitoring side effects. Results In the first 8 weeks of treatment hemoglobin concentration increased from 64.5±12.9 glL to 98.3±16.1 g/L (p<0.0005) in the intra peritoneally treated group. In the subcutaneously treated group hemoglobin increased significantlyfaster (p<0.05) from 72.5±4.8 g/L to 119.2±11.3 g/L (p<0.0005) in the same period. Antihypertensive medication had to be increased or instituted in most of the patients in both groups. The incidence of peritonitis in the intraperitoneally treated group was not increased when compared to the pretreatment incidence. Conclusions Subcutaneously administered rHuEPO is superior to intraperitoneally administered rHuEPO with regard to the required dosages. However, the results of this study show that intraperitoneal administration of rHuEPO might be a convenient and safe alternative when subcutaneous administration is undesirable.

scholarly journals Comparison between subcutaneous ketamine with intramuscular pethidine versus intramuscular pethidine for post-operative analgesia after cesarean section

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B M E Noureldin ◽  
M M Kamal ◽  
A A A Bedewy ◽  
H M M Sultan
Keyword(s):  
Cesarean Section ◽  
Total Dose ◽  
Pain Control ◽  
Well Being ◽  
University Hospitals ◽  
Common Procedure ◽  
Operative Care ◽  
Group A ◽  
Group B ◽  
The Cost

Abstract Background Cesarean section is one of the most common operations. Women undergoing cesarean delivery should achieve adequate postoperative pain relief because of different factors related to the operation complications as well as maternal and neonatal well-being. Immobility due to inadequate pain control could result in thrombo-embolic events, inappropriate neonatal care and delay in discharge which consequently increase the cost of this common procedure both for patients and health care system. Objective to investigate the efficacy of adding subcutaneous ketamine for postoperative analgesia in cesarean section and comparing it to using intramuscular pethidine only regarding opioid requirements and pain level. Patients and Methods The present study was carried out on two groups of women (each group consists of 25) after undergoing cesarean section under spinal anesthesia in Ain Shams University Hospitals and Helwan University Hospitals. Group A patients were given three doses of subcutaneous ketamine (0.9 mg/kg) at post-operative care unit (PACU), 12 and 24 hours after the operation with intramuscular pethidine (50mg) given when patients’ numerical pain score exceeded 5. Group B patients were given three doses of placebo at same intervals as group A and were given intramuscular pethidine (50mg) when NRS score exceeded 5. Results There was significant decrease in pain scores between two groups PACU, 12 and 24 hours postoperative with no significant change in the rest of the study. There was highly significant increase in the time to first pethidine demand in group A than B. There was highly significant decrease in total dose of pethidine given (in group A than in B. Conclusion Subcutaneous ketamine with a dose of (0.9mg/kg) can be used in reducing pain in postoperative period after CS with minimal side effects. The addition of SC ketamine to the pethidine appear to cause more pain control and decrease the total dose of pethidine given in post-operative period.

scholarly journals To compare efficacy of Diclofenac by intramuscular route and rectal route in post surgical pain.

2021 ◽  
Vol 28 (09) ◽  
pp. 1269-1275
Author(s):  
Maryam Zulfiqar ◽  
Maimoona Ashraf ◽  
M. Imran Hassan Khan ◽  
Fareed Naeem ◽  
Salman Shakeel
Keyword(s):  
General Hospital ◽  
Cesarean Delivery ◽  
Diclofenac Sodium ◽  
Randomized Study ◽  
Double Blind ◽  
Surgical Pain ◽  
Rectal Route ◽  
Group A ◽  
Group B ◽  
Study Setting

Objective: This study was carried out in Lahore General Hospital, Lahore to test the results of Intramuscular vs Suppository form of Diclofenac Sodium on the severity of post-surgical pain in patients who underwent Cesarean delivery under Subarachnoid Block. Study Design: Randomized Study. Setting: Lahore General Hospital, Lahore. Period: April 2019 to September 2019. Material & Methods: This was a double-blind run on 100 patients who underwent for cesarean delivery irrespective of any indication for the procedure. The pain sufferers had been randomly divided into 2 groups. The group A: who received Diclofenac Sodium in the form of suppository and Group B: who received intramuscular Diclofanec Sodium? The pain severity was assessed using VAS scale at categorically unique times. Data was then analyzed using SPSS 23 version and the results were compiled in the form of mean and percentage. Results: The mean age (Years) of patients was (25.27±6.07). There was a big statistical difference between the 2 groups regarding pain score after the intervention (p=0.018). Conclusion: To reaffirm the effectiveness of Diclofenac for Post-Caesarean section, the physique part (Suppository) is established to hold advantages over the contractile organ (muscles).

scholarly journals GESTATIONAL DIABETES

2015 ◽  
Vol 22 (10) ◽  
pp. 1298-1303
Author(s):  
Tayyaba Majeed ◽  
Rabia Adnan ◽  
Irum Mubshar ◽  
Hamis Mahmood ◽  
Kanwal Saba ◽  
...  
Keyword(s):  
Oral Route ◽  
Outcome Study ◽  
Neonatal Hypoglycemia ◽  
Consecutive Sampling ◽  
Pregnant Females ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
Study Setting

Objectives: To compare the efficacy of Metformin with insulin in gestationaldiabetes mellitus in terms of fetomaternal outcome. Study Deign: Randomized clinicaltrial study. Setting: Lady Aitchison Hospital Lahore. Period: January 2014 to March 2015.Methodology: Total 500 pregnant females with GDM were included in the study through nonprobability,consecutive sampling. Patients were divided into 2 equal groups (A: B). Patientsin group A were given tablet metformin 500 mg by oral route and group B was administratedregular injection Insulin by subcutaneous route. Results: The mean age of females was32.14±6.13 years. The mean gestational age was 31.07±3.8 weeks. There were 78 (15.6%)females who had 0 parity, 107 (21.4%) females had parity 1, 175 (35%) females had parity2, 95 (19%) females had parity 3, 33 (6.6%) females had parity 4 and 12 (2.4%) femaleshad parity 5.There were 54 (10.8%) cases had PTB, out of which 12 (4.8%) had PTB withmetformin while 42 (16.8%) had PTB with insulin. There were 115 (23%) neonates requiredNICU admission, out of which 37 (14.8%) neonates with metforminand78 (31.2%) neonateswith insulin. There were 87 (17%) neonates who had neonatal hypoglycemia, out of which23 (9.2%) neonates with metformin and64 (25.6%) neonates with insulin. The difference wassignificant between both groups for all fetal outcomes (P<0.05). Conclusion: The metforminis more effective in preventing adverse fetal and maternal outcome as compared to insulin.

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