What is Epoetin alfa / beta / zeta - Meaning and definition

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: November 20, 2018.

Alfa / beta
A recombinant therapeutic agent that is chemically identical to or similar to the endogenous cytokine human erythropoietin (EPO).
Produced primarily by cells of the peritubular capillary endothelium of the kidney in response to hypoxia, circulating EPO binds to EPO receptors on the surface of committed erythroid progenitors in the bone marrow, resulting in their replication and maturation into functional erythrocytes.
Zeta
A recombinant form of the endogenous human cytokine erythropoietin (EPO) with erythropoiesis-stimulating activity. Similar to EPO, epoetin zeta binds to and activates erythropoietin receptors on the surface of committed erythroid progenitors in the bone marrow, resulting in their proliferation and differentiation into functional erythrocytes. This may enhance red blood cell counts and hemoglobin levels. Epoetin zeta differs from other epoetins in its glycosylation profile. EPO is a glycosylated polypeptide primarily produced by renal peritubular cells and its synthesis is regulated by a serum oxygenation feedback mechanism.

National Cancer Institute. NCI Drug Dictionary. Internet. September 15, 2009.

Published by Roberto Wenk. Last updated date: February 8, 2016.

Indications: Anemia associated with chronic renal failure, cancer chemotherapy and chronic disease.

There is robust evidence for benefit in patients receiving anticancer therapy; apart from increasing hemoglobin (Hb), it also reduces fatigue, increases energy, and quality of life.

The FDA has issued guidelines regarding its use:
- Epoetin products should be used only for their approved indications
- They should not be used in cancer patients not on chemotherapy
- The dose recommendations should be strictly adhered to
- Cancer patients on chemotherapy should receive the lowest possible dose to relieve the symptoms of anemia
- The target Hb should not be more than 12g/dl
- If the Hb rises above 12g/dl or more than 1g/dl in any 2-week period, the next dose should be withheld.

Dose: 10,000 units three times weekly increasing to 20,000 units three times weekly. Alternatively 40,000 units may be given weekly increasing to up to 60,000 units. It takes 4-8 weeks for the Hb to increase by 1-2 g/dl.

Adverse effect: Thrombotic episodes, flu-like symptoms.

Disdavantage: Cost

Yennurajalingam S, Bruera E. Fatigue and Asthenia. Hanks G, Cherny NI, Christakis NA, Fallon M, Kaasa S, Portenoy RK (Ed). Oxford Textbook of Palliative Medicine. Oxford University Press, Fourth Edition, 2010, pp. 916-927.

Epoetin alfa / beta / zeta

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