EPO in traumatic brain injury: two strikes…but not out?

Abstract

Despite past failures, 1 Janowitz T Menon DK Exploring new routes for neuroprotective drug development in traumatic brain injury. Sci Transl Med. 2010; 2: 27rv1 Crossref PubMed Scopus (56) Google Scholar the promise of clinical neuroprotection in traumatic brain injury continues to drive the assessment of new compounds. The latest of these compounds is erythropoietin, a haemopoietic growth factor from the type 1 cytokine superfamily, which, through several non-haemopoietic mechanisms, has been shown to be neuroprotective in experimental traumatic brain injury. 2 Ponce LL Navarro JC Ahmed O Robertson CS Erythropoietin neuroprotection with traumatic brain injury. Pathophysiology. 2013; 20: 31-38 Summary Full Text Full Text PDF PubMed Scopus (49) Google Scholar In The Lancet, Alistair Nichol and colleagues 3 Nichol A French C Little L et al. for the EPO-TBI Investigators and the ANZICS Clinical Trials GroupErythropoietin in traumatic brain injury (EPO-TBI): a double-blind randomised controlled trial. Lancet. 2015; (published online Oct 7.)http://dx.doi.org/10.1016/S0140-6736(15)00386-4 PubMed Google Scholar report the results of EPO-TBI, a double-blind, randomised clinical trial of a safety-adaptive dose regimen of erythropoietin (40 000 units subcutaneously once per week for a maximum of three doses) versus placebo, in 606 patients with traumatic brain injury admitted to an intensive care unit, with treatment initiated within 24 h of injury. Erythropoietin in traumatic brain injury (EPO-TBI): a double-blind randomised controlled trialFollowing moderate or severe traumatic brain injury, erythropoietin did not reduce the number of patients with severe neurological dysfunction (GOS-E level 1–4) or increase the incidence of deep venous thrombosis of the lower limbs. The effect of erythropoietin on mortality remains uncertain. Full-Text PDF