SCCM: Recombinant Human Erythropoietin Dramatically Reduces Blood Transfusion Rate in Long-Term Acute Care Patients
By: Jill Stein, Special to DG News

SAN ANTONIO, TX -- January 31, 2003 -- New findings suggest that administering recombinant human erythropoietin to patients admitted to a long-term acute care facility significantly reduces their need for allogeneic blood, investigators reported on January 30th at the Society of Critical Care Medicine's 32nd Critical Care Congress.

Dr. Michael Silver and Dr. Andrea Bazan of the Kindred Hospitals in Chicago, Illinois, randomized 86 long-term acute care patients to receive 12 weekly doses of recombinant human erythropoietin (40,000 units) or placebo administered subcutaneously while in the long-term acute care facility. All subjects received supplemental iron. The study's transfusion guidelines stipulated that the patient would not be transfused if the haemoglobin level exceeded 8 g/dL or the haematocrit level exceeded 24% unless there was a specific clinical indication. Transfusion was indicated when the haemoglobin level was 8 g/dL or lower, at the physician's discretion.

The primary efficacy end point was cumulative units of transfused blood. The trial design excluded patients in renal failure receiving dialysis, those with uncontrolled hypertension, or new onset or uncontrolled seizures.

Compared with subjects in the placebo-treated group, those in the recombinant human erythropoietin-treated group had a more than 50% reduction in the likelihood of receiving any red blood cell transfusions, Dr. Silver said. They also had a more than 50% reduction in the cumulative number of red blood cells transfused. The benefits of recombinant human erythropoietin were observed at day 42 and persisted, but did not increase in magnitude, through day 84. No concerns were identified with regard to safety end points.

"The main message is that the safety and efficacy data related to recombinant human erythropoietin use in long-term acute care patients are solid," Dr. Silver said. "It works, and it reduces patients' dependency on blood by a huge amount." He also noted that at any given time, there are about 11,000 patients in long-term acute care facilities in the United States.

The study was funded by Ortho Biotech Products, L.P., in Bridgewater, New Jersey.