Spinowitz B
Albert Einstein College of Medicine, Bronx, New York.
Am J Nephrol. 1990;10 Suppl 2:24-8. doi: 10.1159/000168213.
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.
多项美国多中心试验提供了关于重组人促红细胞生成素益处的丰富经验。文中呈现了使用β-促红细胞生成素获得的剂量-反应关系。对从这些试验得出的最佳剂量需求相关建议进行了综述。讨论了低剂量疗法对血细胞比容的影响及其降低输血需求的能力。还在不良事件可能减少的背景下研究了低剂量疗法。探讨了给药方案,包括每周一次与每周三次静脉注射疗法。根据目前可用的药代动力学数据讨论了皮下注射疗效的初步信息。强调了在所有剂量下充足铁储备的重要性。无论给药途径如何,铁储备水平都至关重要。