A review on pharmacological use of recombinant human erythropoietin in renal and nonrenal anemia and other potential applications in clinical practice

The introduction of recombinant human erythropoietin (rHuEPO) has revolutionized the treatment of patients with anemia of chronic renal disease. Clinical studies have demonstrated that rHuEPO is also useful in various nonuremic conditions, including hematological and oncological disorders, prematurity, HIV infection, and perioperative therapies. Since the cloning and first clinical introduction of recombinant erythropoietin (epoetin) in the late 1980s, indications and usage of epoetin have expanded significantly. It is estimated that as many as one-third of patients with substantial anemia (hemoglobin less than 10.0 g/dl) resulting from chemotherapy for cancer are treated with epoetin. Research suggests there is considerable variation in epoetin usage in practice. This review highlights the applications of rHuEPO in clinical practice and also addresses the usage of recombinant erythropoietin in situations where benefit is substantiated by high-quality studies.