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Erythropoietin for anyone?
Erythropoietin (EPO), and its analogue, darbepoetin alfa (DPA), stimulate erythropoiesis in all humans and research in clinical scientists. Recently, the effects of EPO and DPA as neuroprotectors have come under the spotlight. The most important recent addition to this literature is a meta-analysis, by Fischer et al (doi: 10.1542/peds.2016-4317), of 4 trials which evaluated the effect of early administration of recombinant human EPO on developmental outcome at 18 to 24 months in babies <32 weeks. The headline result was that EPO reduced the odds of having a Bayley MDI of less than 70 by half, which should translate into a major advantage for using EPO routinely in these high risk babies. A note of caution: 86 other trials were identified but excluded because developmental outcome in the 18 – 24 month window was not reported. But favouring the benefit of EPO is that its advantage persisted at school age when compared to both placebo or term controls Ohls et al (Pediatrics 2016;137:e20153859). And finally, Mulkey et al (doi: 10.1016/j.jpeds.2017.03.053) report an RCT of EPO in hypoxic-ischaemic encephalopathy which suggests that EPO, added to …
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