Risks and Benefits Associated with High Therapeutic Doses of Erythropoiesis Stimulating Agents
Pp. 81-97 (17)
Sandra Ribeiro, Elísio Costa, Flávio Reis and Alice Santos-Silva
The introduction of erythropoiesis stimulating agents (ESAs) for the
treatment of anemia in chronic kidney disease patients and chemotherapy-induced
anemia associated with non-myeloid malignancies, improved the quality of life in these
patients. Recently, several pleiotropic effects have been attributed to ESAs, especially
under doses higher than the doses used to treat anemia. However, recent studies have
raised some concerns about the use of high doses in patients that do not respond
properly to the therapy. To use the pleiotropic actions of ESAs new molecules have
been developed, that do not present hematopoietic actions. In this book chapter, we
present a review of the risks and benefits associated with the use of high ESAs. We also
present the recent proposal for new agents based on the EPO molecule and actions.
Anemia, Erythropoiesis stimulating agents, ESAs benefits, ESAs
risks, High doses, ESAs pleiotropic effects.
Departamento de Ciências Biológicas, Laboratório de Bioquímica, Faculdade de Farmácia da Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.