Off-label use of erythropoietin may be harmful, doctors are told

BMJ 2007; 335 doi: (Published 13 September 2007) Cite this as: BMJ 2007;335:532
  1. David Spurgeon
  1. Quebec

    Doctors should be vigilant about the off-label use of erythropoietin to treat anaemia in critically ill patients, says an early release editorial in the journal of the Canadian Medical Association.

    The editorial (CMAJ 2007;177:697 doi: 10.1503/cmaj.071223) is available on the journal's website ( and is based on a meta-analysis in the journal.

    Recombinant erythropoietin, a complex glycoprotein hormone, is approved for the treatment of anaemia in patients on dialysis, patients who have had major surgery, and those undergoing treatment for cancer.

    When used off label to treat critically ill patients the drug, which costs about $400 (£200; €290) a dose, will save, on average, less than one unit of blood, will not improve clinical outcomes, and may increase the likelihood of …

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