Efficacy and safety of erythropoietin for traumatic brain injury

BMC Neurology

Zhifeng Jiang¹  Ziv Williams²  Amy J. Wang²  Dongliang Shi³  Kejia Hu⁴  Bomin Sun⁴  Motao Liu⁴  Xinbang Wang⁵  Hua He⁶  Yu Chen⁷  Tiansong Zhang⁸  Gexin Zhao⁹ 

[1] Department of Neurosurgery, Ji Zhong Energy Fengfeng Group General hospital;Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School;Department of Neurosurgery, No.904th Hospital of The People’s Liberation Army Joint Logistics Support Force;Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine;Department of Neurosurgery, The PLA Navy Anqing Hospital;Department of Neurosurgery, Third Affiliated Hospital, Second Military Medical University;Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University;Department of Traditional Chinese Medicine, Jing-an District Central Hospital;State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center;

关键词: Erythropoietin;    Traumatic brain injury;    Mortality;    Neurological function improvement;    Adverse events;    Meta-analysis;   

DOI  :  10.1186/s12883-020-01958-z

来源: DOAJ

【 摘 要 】

Abstract Background Recent studies regarding the effects of erythropoietin (EPO) for treating traumatic brain injury (TBI) have been inconsistent. This study conducts a meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of EPO for TBI patients at various follow-up time points. Methods A literature search was performed using PubMed, Web of Science, MEDLINE, Embase, Google Scholar and the Cochrane Library for RCTs studying EPO in TBI patients published through March 2019. Non-English manuscripts and non-human studies were excluded. The assessed outcomes include mortality, neurological recovery and associated adverse effects. Dichotomous variables are presented as risk ratios (RR) with a 95% confidence interval (CI). Results A total of seven RCTs involving 1197 TBI patients (611 treated with EPO, 586 treated with placebo) were included in this study. Compared to the placebo arm, treatment with EPO did not improve acute hospital mortality or short-term mortality. However, there was a significant improvement in mid-term (6 months) follow-up survival rates. EPO administration was not associated with neurological function improvement. Regarding adverse effects, EPO treatment did not increase the incidence of thromboembolic events or other associated adverse events. Conclusions This meta-analysis indicates a slight mortality benefit for TBI patients treated with EPO at mid-term follow-up. EPO does not improve in-hospital mortality, nor does it increase adverse events including thrombotic, cardiovascular and other associated complications. Our analysis did not demonstrate a significant beneficial effect of EPO intervention on the recovery of neurological function. Future RCTs are required to further characterize the use of EPO in TBI.

【 授权许可】

Unknown