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Joydeep Sarkar, Alka A Potdar, Gerald M Saidel
Iron plays vital roles in the human body including enzymatic processes, oxygen-transport via hemoglobin and immune response. Iron metabolism is characterized by ~95% recycling and minor replenishment through diet. Anemia of chronic kidney disease (CKD) is characterized by a lack of synthesis of erythropoietin leading to reduced red blood cell (RBC) formation and aberrant iron recycling. Treatment of CKD anemia aims to normalize RBC count and serum hemoglobin. Clinically, the various fluxes of iron transport and accumulation are not measured so that changes during disease (e...
April 16, 2018: PLoS Computational Biology
Andrei M Beliaev, Sara J Allen, Paget Milsom, Parma Nand, Warren M Smith, Colleen J Bergin
BACKGROUND: Jehovah's Witnesses who refuse blood transfusion have high mortality. Erythropoietin (EPO) has been used as an alternative to blood transfusion. The optimal dosing of EPO in anaemic Jehovah's Witnesses is unknown. The aim of our study was to evaluate the clinical benefits of treatment with a low dose (<600 IU/kg/week) of epoietin beta (EPO-β). MATERIALS AND METHODS: This was an observational study, retrospectively considering a 10-year period during which 3,529 adult Jehovah's Witnesses with a total of 10,786 hospital admissions were identified from databases of four major public hospitals in New Zealand...
January 2018: Blood Transfusion, Trasfusione del Sangue
Dominique Levêque
Biosimilar drugs are biologic drugs clinically similar to the reference products. They correspond to a generic approach applied to biologic agents. Biosimilars are aimed to provide cheaper drugs by enhancing the concurrency. The approval of biosimilars is abbreviated when compared to that of the reference biologics but includes clinical trials (distinguishing them from the generics). Current available biosimilars in oncology are filgrastim and epoietin alpha. In the next future, will be launched rituximab and trastuzumab...
March 2016: Bulletin du Cancer
Rosa Zampino, Loredana Alessio, Aldo Marrone, Maria Stanzione, Adriana Boemio, Anna Grandone, Carmine Minichini, Mariantonietta Pisaturo, Mario Starace, Luigi Elio Adinolfi, Evangelista Sagnelli, Nicola Coppola
The inosine triphosphatase (ITPA) gene and interleukin 28B (IL28-B) gene variants have been associated to protection of anemia and sustained virological response, respectively, in patients with chronic hepatitis C (CHC) during antiviral therapy. Aim of this study was to evaluate the single and combined role of both polymorphisms in the management of peg-interferon-ribavirin treatment in CHC patients. We studied 79 Italian patients with histology proven CHC treated with pegylated interferon plus ribavirin for 6-12 months on the base of HCV genotype...
June 2015: Le Infezioni in Medicina
N A Romanenko, S S Bessmel'tsev, M V Berkos, O E Rozanova, K M Abdulkadyrov
AIM: To clarify the prognostic value of the baseline blood levels of endogenous erythropoietin (EE) and tumor necrosis factor-a (TNF-a) involved in the key components of the pathogenesis of anemia in lymphoproliferative diseases (LPD), the counts of reticulocytes and platelets (hematopoietic preservation indicators) in the use of erythropoiesis-stimulating agents (ESAs) to correct anemia syndrome (AS) in patients with LPD. SUBJECTS AND METHODS: The results of AS treatment with ESAs were analyzed in 48 patients with LPD...
2013: Terapevticheskiĭ Arkhiv
N Marangon, K Hadaya
Individualized prescription of bicarbonate solutions allows one to control metabolic acidosis. Low sodium solutions improve sodium removal and may become available in the future. Varying dwell time and fill volume when intermittent APD is prescribed improves the efficiency of dialysis. Continuous flow peritoneal dialysis can dramatically improves the efficiency of dialysis. Normalized haemoglobin values by epoietin-beta in renal transplant recipients are associated with a better graft survival at 2 years. Switch from calcineurins inhibitors to sirolimus after the first squamous-cell carcinoma lead to significantly longer survival free of cutaneous carcinoma at 2 years...
January 16, 2013: Revue Médicale Suisse
Y Bennis, G Sarlon-Bartoli, B Guillet, L Lucas, L Pellegrini, L Velly, M Blot-Chabaud, F Dignat-Georges, F Sabatier, P Pisano
BACKGROUND:  Endothelial colony-forming cells (ECFCs) are promising candidates for cell therapy of ischemic diseases. Erythropoietin (EPO) is a cytokine that promotes angiogenesis after ischemic injury. EPO receptors (EPORs) classically include two EPOR subunits, but may also associate with the β-common chain (CD131) in a newly identified receptor involved in EPO cytoprotective effects. OBJECTIVE: The aim was to take advantage of the proangiogenic properties of EPO to enhance ECFC graft efficiency...
September 2012: Journal of Thrombosis and Haemostasis: JTH
Anna Jander, Ryszard Wierciński, Irena Bałasz-Chmielewska, Monika Miklaszewska, Katarzyna Zachwieja, Halina Borzecka, Jacek Zachwieja, Irena Olszak-Szot, Dariusz Kubicki, Helena Ziółkowska, Jacek Rubik, Maria Szczepańska, Dariusz Runowski, Wojciech Fendler, Marcin Tkaczyk
OBJECTIVE: Erythropoiesis-stimulating agents (ESAs) are applied as a standard therapy in children with anaemia in chronic kidney disease. The aim of this study was to describe the efficacy and details of ESA treatment in a population of dialysed children in Poland. MATERIAL AND METHODS: The study had a prospective observational design and was performed in 12 dialysis centres. The study group comprised 117 dialysed children with a mean age at enrolment of 165.33 (97...
October 2012: Scandinavian Journal of Urology and Nephrology
Didier Kamioner
The discovery of epoietin (EPO) and the cloning of its gene facilitated the understanding of the mechanism of control behind red blood cell formation. This cloning was followed by the commercial development of recombinant human EPO (rHuEPO). The use of erythropoiesis-stimulating agents (ESAs) (epoietin, ESA, EPO) is important for the treatment of anemia in patients with chronic renal failure and cancer patients with chemotherapy-induced anemia. After several years of discussions, debates and questions, ESA, intravenous iron and blood transfusions seem to have finally found their respective indications in the treatment of anemia in cancer patients receiving chemotherapy...
March 2012: Targeted Oncology
Giovanni F M Strippoli
BACKGROUND: Anemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are commonly used to increase hemoglobin levels in this population. In observational studies, higher hemoglobin levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to hemoglobin levels around 9-10 g/dL. A systematic review of randomized trials found that targeting higher hemoglobin levels with ESA causes an increased risk of adverse vascular outcomes...
June 9, 2010: Trials
Edin Ostrvica, Enisa Mesic, Dzenana Ostrvica, Jasmin Delic, Sunita Delic-Custendil, Fatima Hukic
INTRODUCTION: Anemia is an early sign of chronic kidney dysfunction, caused by many different factors, but the insufficient erythropoietin synthesis is the crucial factor in its development. OBJECTIVES: The objective of our study was to compare effectiveness of epoietin alpha and beta application in the treatment of renal anemia in chronic hemodialyzed patients. PATIENTS AND METHODS: The group included 60 patients of both sexes, randomly chosen...
2010: Medicinski Arhiv
Swati DebRoy, Christopher Kribs-Zaleta, Anuj Mubayi, Gloriell M Cardona-Meléndez, Liana Medina-Rios, MinJun Kang, Edgar Diaz
The combination therapy of antiviral peg-interferon and ribavirin has evolved as one of the better treatments for hepatitis C. In spite of its success in controlling hepatitis C infection, it has also been associated with treatment-related adverse side effects. The most common and life threatening among them is hemolytic anemia, necessitating dose reduction or therapy cessation. The presence of this side effect leads to a trade-off between continuing the treatment and exacerbating the side effects versus decreasing dosage to relieve severe side effects while allowing the disease to progress...
June 2010: Mathematical Biosciences
P M Ter Wee, Y de Koter, O van der Veer, M H van Vliet
Although immediate pain sensation at the injection site is reported by patients, only limited data on comparison of pain at the injection site between erythropoiesis stimulating agents are available. Therefore, we compared the effect of subcutaneous epoietin-beta on immediate pain sensation to that of subcutaneous darbepoietin-alpha in a double blind, randomized controlled study. Adult patients, aged 18 - 75 years, treated with peritoneal dialysis or with stage 4 chronic kidney disease who in our unit are treated with subcutaneous darbepoietin-alpha for renal anemia for at least 3 months, were eligible for the study...
September 2009: Clinical Nephrology
Stéphane Picot, Anne-Lise Bienvenu, Salimata Konate, Sibiri Sissoko, Abdoulaye Barry, Elisabeth Diarra, Karidiatou Bamba, Abdoulaye Djimdé, Ogobara K Doumbo
BACKGROUND: Cerebral malaria carries an unacceptable case fatality rate in children despite timely and adequate chemotherapy. To improve the survival rate, adjunctive therapies previously tested mainly focused on the modulation of the inflammatory response, without definitive effect in humans. In this context, a new adjunctive strategy using a neuroprotective drug: erythropoietin (epoietin-beta, Epo) was proposed. METHODS: An open-labelled study including cerebral malaria children (Blantyre coma score below 3) was conducted in Mali...
July 24, 2009: Malaria Journal
Felicita Andreotti, Luciano Agati, Elena Conti, Eleonora Santucci, Teresa Rio, Federica Tarantino, Luigi Natale, Daniele Berardi, Antonella Mattatelli, Beatrice Musumeci, Lorenzo Bonomo, Massimo Volpe, Filippo Crea, Camillo Autore
Erythropoietin (Epo) is a hematopoietic hormone produced mainly by the kidneys in response to hypoxia. Recent acquisitions in the fields of hematology, neurology, cardiology, and experimental medicine show cytoprotective, angiogenetic and antiinflammatory effects of Epo. Exogenous erythroPoietin in Acute Myocardial Infarction: New Outlook aNd Dose Association Study (EPAMINONDAS, EudraCTno. 200500485386) is one of four ongoing randomized controlled trials, each testing the effects of Epo in >or=100 patients with STEMI...
November 2009: Journal of Thrombosis and Thrombolysis
P Monostori, Z Hracskó, E Karg, I S Varga, Z Kiss, T Boros, E Kiss, I Haszon, F Papp, V Sümegi, C Bereczki, S Túri
AIMS: Variation of the action of erythropoiesis-stimulating agent (ESA) may modify oxidative stress in hemodialyzed (HD) patients. Our aim was to follow changes of oxidative stress during withdrawal and subsequent resumption of ESA therapy. PATIENTS AND METHODS: After a 14-day suspension of epoietin-beta treatment, 11 HD patients received epoietin-beta and 10 patients darbepoietin-alpha. The whole blood oxidized and reduced glutathione (GSSG, GSH) and erythrocyte malondialdehyde (E-MDA) concentrations and the erythrocyte superoxide dismutase (E-SOD) and catalase (E-CAT) activities were determined before the ESA-free interval (baseline) and at Weeks 2, 6, 10 and 14...
May 2009: Clinical Nephrology
Jean-Michel Laffosse, Vincent Minville, Philippe Chiron, Aline Colombani, Claude Gris, Jean-Claude Pourrut, Bernard Eychenne, Olivier Fourcade
OBJECTIVE: Epoietin (EPO) effectively decreases perioperative blood transfusion requirements. We evaluated the feasibility of using EPO beta to increase haemoglobin levels before total hip replacement (THR) and reduce transfusion. MATERIALS AND METHODS: One hundred and seventy-one patients undergoing primary THR were included in this prospective observational study. Patients with initial haemoglobin level <130 g l−1 received EPO beta subcutaneously in a four-dose regimen...
January 2010: Archives of Orthopaedic and Trauma Surgery
Vasilis Tsimihodimos, Evangelia Dounousi, Kostas C Siamopoulos
BACKGROUND/AIMS: Cardiovascular disease (CVD) is a major cause of mortality in patients with mild to moderate chronic kidney disease (CKD) and end-stage renal disease (ESRD). Dyslipidemia has been established as a well-known traditional risk factor for CVD in the general population and it is well known that patients with CKD exhibit significant alterations in lipoprotein metabolism. In this review the pathogenesis and treatment of renal dyslipidemia are discussed. METHODS: Studies on lipid abnormalities in CKD stages 1-4, in nephrotic syndrome, and in hemodialysis and peritoneal dialysis patients are analyzed, as well as the lipid profile of kidney graft recipients...
2008: American Journal of Nephrology
H G Mar Fan, A Park, W Xu, Q-L Yi, S Braganza, J Chang, F Couture, I F Tannock
OBJECTIVE: Cognitive dysfunction is a potential side effect of chemotherapy, and erythropoietin might be protective. A previously reported study compared quality-of-life in women undergoing chemotherapy for breast cancer who were randomized to receive epoetin-alpha or standard care. Here, we report a non-randomized sub-study in which cognitive function of participants was evaluated at 12-30 months after chemotherapy. METHODS: The primary endpoint was the proportion of women with moderate-severe cognitive impairment, as measured by the High Sensitivity Cognitive Screen (HSCS)...
February 2009: Psycho-oncology
M Hedenus, G Birgegård
UNLABELLED: Cancer-related anemia is common and multifactorial in origin. Functional iron deficiency (FID) is now recognized as a cause of iron-restricted erythropoiesis and may be one of the major reasons for lack of response to treatment with Erythropoietic Stimulating Agents (ESAs). Numerous studies have shown that intravenous (IV), but not oral, iron therapy effectively provides sufficient iron for optimal erythropoiesis in anemic patients with chronic renal disease receiving ESA therapy...
2009: Medical Oncology
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