Treatment of a Unique Anemia in Patients With IDDM With Epoetin Alfa
- Mark U Rarick, MD,
- Byron M Espina, BS,
- Daniel T Colley, PHARMD,
- Aaron Chrusoskie, BS,
- Shannan Gandara, BS and
- Donald I Feinstein, MD
- Division of Hematology/Oncology Kaiser Permanente, Portland, Oregon
- Department of Medicine, University of Southern California School of Medicine Los Angeles, California
- Address correspondence to Mark U. Rarick, MD, Kaiser Permanente, Central Interstate Medical Office, 3600 N. Interstate Ave., Portland, OR 91221. E-mail: rarickma{at}chr.mts.kpnw.org
Abstract
OBJECTIVE To identify and treat a unique form of anemia in patients with long-term IDDM.
RESEARCH DESIGN AND METHODS Patients with IDDM, unexplained symptomatic anemia, and serum creatinine levels of < 177 μmol/l (2.0 mg/dl) were treated with epoetin alfa (Procrit, Ortho Biotech, Raritan, NJ), 50 U/kg three times weekly, subcutaneously, to reach a target hematocrit of 38–40%. Baseline serum erythropoietin titers were measured before drug therapy.
RESULTS Six patients were treated with epoetin alfa. Median age of the group was 74 years, with IDDM being diagnosed for a median of > 20 years. All patients had symptoms of anemia with a median hematocrit of 28.9% (range 27–31). Compared with iron deficiency control patients, the group had a limited erythropoietin (EPO) response to the degree of anemia. All patients showed increases in hematocrit, median peak of 40.9%, with median time-to-peak response of 12 weeks. Baseline symptoms of anemia resolved in all patients. No adverse effects were noted during the treatment period.
CONCLUSIONS There is a unique form of anemia in patients with long-term IDDM and clinically normal renal function who respond to low-dose epoetin alfa therapy. The rapid response to therapy and depressed baseline erythropoietin titers suggest the anemia is due to a lack of endogenous EPO release.
- Received March 20, 1997.
- Accepted November 3, 1997.
- Copyright © 1998 by the American Diabetes Association
