Erythropoietin and other erythropoiesis-stimulating drugs and bloodless medicine – a new era in the management of anaemia?
Authors:
Stibor Bronislav; Schwameis Franz
Authors‘ workplace:
Abteilung für Anästhesie und Intensivmedizin, Landesklinikum Baden, Baden bei Wien, Rakousko
Published in:
Anest. intenziv. Med., 20, 2009, č. 2, s. 84-87
Category:
Anaesthesiology - Review Article
Overview
Bloodless medicine tries to find and put into practice alternatives to allogeneic transfusions. The biggest risk when receiving a blood transfusion is the transmission of infectious diseases. Since the 1980s the recombinant human erythropoietin has been used in anaemia treatment, the first of the group of erythropoiesis stimulating agents. Its main disadvantage is the need for frequent applications; a very serious complication – pure red-cell aplasia - occurs rarely.
A second generation drug – darbepoetin – features a modified chemical structure and more favourable pharmacokinetics. A third generation representative of continuous erythropoietin receptor activators will soon be introduced into clinical practice featuring a many times longer biological half-time. The forth generation represents a qualitative leap with oral preparations made up without the help of genetic engineering, starting a new era in anaemia management. However, only the introduction of artificial blood into clinical practice will make blood transfusion a rare procedure.
Keywords:
bloodless medicine – erythropoiesis stimulating agents – erythropoietin – darbepoetin – pure red-cell aplasia – continuous erythropoietin receptor activator – Hematide
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