Possible Interaction: Epoetin Alfa and Iron, Dietary

“Factors that influence the response to epoetin alfa include the dose and timing of treatment (20), coadministration of iron (21, 22), and baseline hemoglobin concentration (23).”

“Thus, a person weighing 70 kg would require a total dose of 168 000 U. … subgroup analysis from a previous study (18), we hypothesized that a high dose of oral iron used in … more prolonged epoetin alfa dosing schedule might produce a better … that obtained with the standard regimen.”

“ Iron availability was a critical factor in determining the response to epoetin alfa.”

“That iron and especially intravenous iron was underused in the EPO group is clear from the rate of both enteric and intravenous iron therapy.”

“The study design recognized that the availability of iron is a limiting factor in the response to EPO and suggested that, “Patients with transferrin saturation value of less than 20% were to receive iron supplementation”.”

“Response to treatment with iron and epoetin is multifactorial, and results are still far from the targets set by the guidelines.”

“ascorbic acid therapy in iron overloaded HD patients receiving Epoetin alfa.”

“It is also increasingly recognized that IV iron can enhance the response to epoetin , even in iron-replete patients.”

“ iron almost certainly outweigh the risks in terms of optimizing the response to epoetin therapy.”

“Resistance to epoetin may be due to iron or vitamin deficiency, natural or exogenous inhibitors of erythropoiesis and bone marrow fibrosis.”

“ Epoetin alfa stimulates erythropoiesis, thus creating an increased need for iron , and virtually all patients with end-stage renal disease who receive this therapy will eventually require iron supplementation.”

“Stimulation of erythropoiesis by Epoetin alfa causes an increased demand for iron to facilitate hemoglobin synthesis.”