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Apr 10, 2003

Dr. Bob,

Do you know anything about aranesp? Is it being used in HIV+ people? Would it be better for me than PROCRIT?

Thanks, Stu

Response from Dr. Frascino

Hello Stu,

Yes, Im well acquainted with Aranesp. Its a red blood cell stimulating protein closely related to erythropoietin (Procrit) that is produced in Chinese hamster ovary cells, using recombinant DNA technology. I wont go into all the details of Chinese hamster ovaries, but I will say that Aranesp stimulates red blood cell production by the same mechanism as our naturally produced erythropoietin. In essence, it works similarly to Procrit.

If its so similar, whats its claim to fame, and is it useful in us HIV positoids? Good question. Glad you asked. Aranesps claim to fame is that its slightly different chemical structure may allow for a longer half-life. That means it might be able to be dosed less frequently than Procrit. As for use in HIV-positive folks, Aranesp does not have an indication for use in us virally enhanced folks. Aranesp is approved for only 2 indications:

1. Anemia associated with chronic renal failure Anemia associated with non-myeloid malignancies (cancers) due to the effect of concomitantly administered chemotherapy.

Should Aranesp be used in HIV+ folks? I would advise caution. First off, there have been no drug interaction studies yet. And you know how many drugs we all take. The possibility of an unanticipated adverse drug interaction is something we definitely dont need! Second, there have been some serious allergic reactions with Aranesp, which again is something we can do without. Aranesp is also contraindicated in patients with uncontrolled high blood pressure.

Bottom line: Would it be better for you than Procrit? No! Procrit has been studied extensively in HIV-positive patients, has an FDA-approved indication for use in HIV-positive patients, and a remarkable record of both safety and efficacy.

Hope that helps. Stu, write back if you have further questions.

Stay well. Stay energized.

Dr. Bob

possibility of converting to positive.
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