Indications

The principal use is in renal failure; priority indicators include:

• transfusion dependency
• angina - heart failure aggravated by anaemia
• haemoglobin concentrations less than 8
• livelihood threatened by anaemia
• prevention of sensitisation to transplantation antigens

Other uses include:

• patients anaemic due to malignant disease - improves anaemia, but quality of life probably not increased
  • there are concerns about using erythopoietin in patients with cancer:
    • study evidence revealed that erythropoiesis-stimulating agent administration to patients with cancer is associated with increased risks of venous thromboembolism (VTE) and mortality (1)
      
      
• rheumatoid arthritis:
  • corrects anaemia
  • results in clinical improvement
    
    
• Jehovah's witnesses:
  • useful following major surgery
    
    
• haematologic disorders:
  • safe and effective in lymphoproliferative disorders
  • less good in haematopoietic disorders
  • iron deficiency is an important cause of failure to respond

Reference:

• 1. Bennett CL et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA. 2008 Feb 27;299(8):914-24