Improved haemoglobin levels with reduced frequency of administration of epoetin alfa

In January 2004, at the Flinders Medical Centre (FMC) 95 patients were receiving erythropoietin, either three times a week intravenous (IV) Eprex (Group A) or two times a week IV Eprex (Group B). Group B patients had measurably improved haemoglobin levels of 12.2 g/dL even with reduced Eprex dosage of 8,875 U/Wk compared to Group A patients with haemoglobin levels of 11.3 g/dL and associated Eprex dosage of 13,696 U/Wk. In May 2004, most haemodialysis (HD) patients at FMC were changed over to a twice a week Eprex dosing regimen and audited prospectively until the end of 2004. Analysis of data from this group of patients at the end of 2004 showed sustained haemoglobin levels at lower Eprex dosing. Ferritin and transferrin saturation (Tsat) levels remained satisfactory indicating adequate iron repletion during this period. Cost and safety benefits were made with less Eprex administered and reduced nursing intervention required. This Eprex regimen was maintained successfully in our dialysis population from 2004 onwards with data measured prospectively from 2008, indicating that the vast majority of patients were given IV Eprex two times a week with haemoglobin levels of 11.8 g/dL and associated Eprex dosage of 10,696 U/Wk comparable with the previous results from the patient cohort receiving twice-weekly Eprex in 2004 (Group B).