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Epoetin zeta is a biosimilar of epoetin alfa and is a recombinant human erythropoietin (rhEPO) produced by recombinant DNA technology in Chinese Hamster Ovary (CHO) cells. It acts as an erythropoiesis-stimulating agent by binding to and activating the erythropoietin receptor on committed erythroid progenitor cells in the bone marrow, leading to their proliferation and differentiation into functional red blood cells. This process increases red blood cell counts and hemoglobin levels, making it effective for treating symptomatic anemia associated with chronic renal failure in adults and children on hemodialysis or peritoneal dialysis, as well as adults with severe renal anemia not yet on dialysis. Epoetin zeta activates the Janus kinase 2 (JAK2) signaling pathway upon receptor binding, which leads to downstream activation of transcription factors necessary for red blood cell production. It was granted marketing authorization by the European Medicines Agency in October 2007[1][2][3][5].
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