Frontiers in Drug Discovery

Frontiers in Drug Discovery

Volume: 1

Erythropoietic Stimulating Agents

Indexed in: EBSCO.

The development of new erythropoietic stimulating agents (ESAs) has significantly increased in recent years. Researchers are focused on different and interesting concepts, namely, methods to increase ...
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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.