Hypoxic-Ischemic Encephalopathy Clinical Trial
Official title:
Effect of Erythropoietin on Neonatal Hypoxic Ischemic Encephalopathy
Perinatal asphyxia-induced brain injury is one of the most common causes of morbidity and mortality in term and preterm neonates, accounting for 23% of neonatal deaths globally. Although many neuroprotective strategies appeared promising in animal models, most of them have failed clinically. Erythropoietin (EPO) is an endogenous cytokine originally identified for its role in erythropoiesis. Clinical trial has demonstrated the safety and efficacy of recombinant human erythropoietin (r-hu-EPO) in the prevention or treatment of anemia of prematurity. To date, there are no reports evaluating possible effects of EPO on neonatal HIE.
Hypoxic-ischemic encephalopathy of the newborn infant remains a significant socio-economic
health problem worldwide. Moderate to severe HIE of newborn infants is associated with a
high rate of death or long-term disabilities. Historically, treatment has been purely
supportive including stabilizing cardio-respiratory functions and treating
convulsions.Recent multi-center trials assessing the effects of hypothermia demonstrated
improved outcome in term neonates with moderate hypoxic-ischemic encephalopathy (HIE).
However, hypothermia was not effective beyond 6 hrs after brain injury.
Systemically administered EPO was neuroprotective in neonatal brain injury models. Clinical
study on adult stroke showed improved outcome. However, treating HIE with EPO raises a
series of questions such as: i) Can the patient population of this study readily be compared
with those in the hypothermia trials? ii) What are the pharmacokinetics of EPO, including
issues of dosage and timing, and does administered EPO cross the blood-brain-barrier? iii)
How does the effectiveness, side effects and potentials of EPO therapy compare with induced
hypothermia?
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Prevention
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