Efficacy and safety of erythropoietin for traumatic brain injury
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...
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| Language: | English |
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BMC
2020-11-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-020-01958-z |
| _version_ | 1829135278856470528 |
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| author | Motao Liu Amy J. Wang Yu Chen Gexin Zhao Zhifeng Jiang Xinbang Wang Dongliang Shi Tiansong Zhang Bomin Sun Hua He Ziv Williams Kejia Hu |
| author_facet | Motao Liu Amy J. Wang Yu Chen Gexin Zhao Zhifeng Jiang Xinbang Wang Dongliang Shi Tiansong Zhang Bomin Sun Hua He Ziv Williams Kejia Hu |
| author_sort | Motao Liu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-14T18:21:10Z |
| format | Article |
| id | doaj.art-d2f4e7b8a80a4978a32114279967b1e8 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-14T18:21:10Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-d2f4e7b8a80a4978a32114279967b1e82022-12-21T22:52:05ZengBMCBMC Neurology1471-23772020-11-0120111310.1186/s12883-020-01958-zEfficacy and safety of erythropoietin for traumatic brain injuryMotao Liu0Amy J. Wang1Yu Chen2Gexin Zhao3Zhifeng Jiang4Xinbang Wang5Dongliang Shi6Tiansong Zhang7Bomin Sun8Hua He9Ziv Williams10Kejia Hu11Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical SchoolDepartment of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical UniversityState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer CenterDepartment of Neurosurgery, Ji Zhong Energy Fengfeng Group General hospitalDepartment of Neurosurgery, The PLA Navy Anqing HospitalDepartment of Neurosurgery, No.904th Hospital of The People’s Liberation Army Joint Logistics Support ForceDepartment of Traditional Chinese Medicine, Jing-an District Central HospitalDepartment of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Neurosurgery, Third Affiliated Hospital, Second Military Medical UniversityDepartment of Neurosurgery, Massachusetts General Hospital, Harvard Medical SchoolDepartment of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract 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.http://link.springer.com/article/10.1186/s12883-020-01958-zErythropoietinTraumatic brain injuryMortalityNeurological function improvementAdverse eventsMeta-analysis |
| spellingShingle | Motao Liu Amy J. Wang Yu Chen Gexin Zhao Zhifeng Jiang Xinbang Wang Dongliang Shi Tiansong Zhang Bomin Sun Hua He Ziv Williams Kejia Hu Efficacy and safety of erythropoietin for traumatic brain injury BMC Neurology Erythropoietin Traumatic brain injury Mortality Neurological function improvement Adverse events Meta-analysis |
| title | Efficacy and safety of erythropoietin for traumatic brain injury |
| title_full | Efficacy and safety of erythropoietin for traumatic brain injury |
| title_fullStr | Efficacy and safety of erythropoietin for traumatic brain injury |
| title_full_unstemmed | Efficacy and safety of erythropoietin for traumatic brain injury |
| title_short | Efficacy and safety of erythropoietin for traumatic brain injury |
| title_sort | efficacy and safety of erythropoietin for traumatic brain injury |
| topic | Erythropoietin Traumatic brain injury Mortality Neurological function improvement Adverse events Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12883-020-01958-z |
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