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High‐dose erythropoietin for tissue protection
Author(s) -
Lund Anton,
Lundby Carsten,
Olsen Niels V.
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12357
Subject(s) - medicine , adverse effect , erythropoietin , clinical trial , placebo , randomized controlled trial , intensive care medicine , myocardial infarction , stroke (engine) , oncology , pathology , alternative medicine , mechanical engineering , engineering
Background The discovery of potential anti‐apoptotic and cytoprotective effects of recombinant human erythropoietin ( rHuEPO ) has led to clinical trials investigating the use of high‐dose, short‐term rHuEPO therapy for tissue protection in conditions such as stroke and myocardial infarction. Experimental studies have been favourable, but the clinical efficacy has yet to be validated. Materials and methods We have reviewed clinical studies regarding the use of high‐dose, short‐term rHuEPO therapy for tissue protection in humans with the purpose to detail the safety and efficacy of rHuEPO for this indication. A systematic literature search was performed using the PubMed/MEDLINE database for randomized, placebo‐controlled clinical trials. Results Twenty‐six randomized controlled trials that enrolled 3176 patients were included. The majority of trials (20 trials including 2724 patients) reported no effect of rHuEPO therapy on measures of tissue protection. Five trials including 1025 patients reported safety concerns in the form of increased mortality or adverse event rates. No studies reported reduced mortality. Conclusions Evidence is sparse to support a tissue‐protective benefit of rHuEPO in humans. Moreover, a number of studies indicate that short‐term administration of high‐dose rHuEPO is associated with an increased risk of mortality and serious adverse events. Further work is needed to elucidate the mechanisms of toxicity of rHuEPO in humans.