Effect of Early Recombinant Human Erythropoietin on Neurodevelopmental Outcomes at Age 5 Years —Reply

In Reply Before exposing preterm infants to erythropoietin for neuroprotection, potential benefits and safety need to be assessed using the highest possible level of evidence by performing randomized clinical trials instead of extrapolating results from retrospective analyses in neonates exposed to diverse doses of erythropoietin for the prevention of anemia of prematurity. Our recent study demonstrated no significant difference in neurodevelopmental outcomes at age 5 years in children born at 26 to 32 weeks ’ gestation treated with early high-dose rhEpo compared with saline during the first 2 days of life. These findings confirm those of the primary outcome analysis at age 2 years and do not support the prophylactic administration of short-term, high-dose rhEpo immediately after birth for neuroprotec tion in the population studied. The outcome data complemented that of the Preterm Erythropoietin Neuroprotection Trial (PENUT), in which infants born between 24 and 28 weeks’ gestation were exposed to rhEpo at lower doses and over a much longer period. Despite methodological differences, both tria ls showed that rhEpo administered immediately after birth was not associated with adverse effects in very preterm neonates.
Source: JAMA - Category: General Medicine Source Type: research