| Title: |
Trial of Erythropoietin for Hypoxic–Ischemic Encephalopathy in Newborns |
| Authors: |
Wu, Yvonne W; Comstock, Bryan A; Gonzalez, Fernando F; Mayock, Dennis E; Goodman, Amy M; Maitre, Nathalie L; Chang, Taeun; Van Meurs, Krisa P; Lampland, Andrea L; Bendel-Stenzel, Ellen; Mathur, Amit M; Wu, Tai-Wei; Riley, David; Mietzsch, Ulrike; Chalak, Lina; Flibotte, John; Weitkamp, Joern-Hendrik; Ahmad, Kaashif A; Yanowitz, Toby D; Baserga, Mariana; Poindexter, Brenda B; Rogers, Elizabeth E; Lowe, Jean R; Kuban, Karl CK; O’Shea, T Michael; Wisnowski, Jessica L; McKinstry, Robert C; Bluml, Stefan; Bonifacio, Sonia; Benninger, Kristen L; Rao, Rakesh; Smyser, Christopher D; Sokol, Gregory M; Merhar, Stephanie; Schreiber, Michael D; Glass, Hannah C; Heagerty, Patrick J; Juul, Sandra E |
| Source: |
The New England Journal of Medicine, vol 387, iss 2 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2022 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
3213 Paediatrics (for-2020); 32 Biomedical and Clinical Sciences (for-2020); Brain Disorders (rcdc); Clinical Research (rcdc); Minority Health (rcdc); Prevention (rcdc); Stroke (rcdc); Neurosciences (rcdc); Pediatric (rcdc); Health Disparities (rcdc); Cerebral Palsy (rcdc); Childhood Injury (rcdc); Cerebrovascular (rcdc); Clinical Trials and Supportive Activities (rcdc); Intellectual and Developmental Disabilities (IDD) (rcdc); Preterm; Low Birth Weight and Health of the Newborn (rcdc); Perinatal Period - Conditions Originating in Perinatal Period (rcdc); Unintentional Childhood Injury (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Reproductive health and childbirth (hrcs-hc); Neurological (hrcs-hc); Administration; Intravenous (mesh); Cerebral Palsy (mesh); Double-Blind Method (mesh); Erythropoietin (mesh); Humans (mesh); Hypothermia; Induced (mesh) |
| Subject Geographic: |
148 - 159 |
| Description: |
BACKGROUND: Neonatal hypoxic-ischemic encephalopathy is an important cause of death as well as long-term disability in survivors. Erythropoietin has been hypothesized to have neuroprotective effects in infants with hypoxic-ischemic encephalopathy, but its effects on neurodevelopmental outcomes when given in conjunction with therapeutic hypothermia are unknown. METHODS: In a multicenter, double-blind, randomized, placebo-controlled trial, we assigned 501 infants born at 36 weeks or more of gestation with moderate or severe hypoxic-ischemic encephalopathy to receive erythropoietin or placebo, in conjunction with standard therapeutic hypothermia. Erythropoietin (1000 U per kilogram of body weight) or saline placebo was administered intravenously within 26 hours after birth, as well as at 2, 3, 4, and 7 days of age. The primary outcome was death or neurodevelopmental impairment at 22 to 36 months of age. Neurodevelopmental impairment was defined as cerebral palsy, a Gross Motor Function Classification System level of at least 1 (on a scale of 0 [normal] to 5 [most impaired]), or a cognitive score of less than 90 (which corresponds to 0.67 SD below the mean, with higher scores indicating better performance) on the Bayley Scales of Infant and Toddler Development, third edition. RESULTS: Of 500 infants in the modified intention-to-treat analysis, 257 received erythropoietin and 243 received placebo. The incidence of death or neurodevelopmental impairment was 52.5% in the erythropoietin group and 49.5% in the placebo group (relative risk, 1.03; 95% confidence interval [CI], 0.86 to 1.24; P = 0.74). The mean number of serious adverse events per child was higher in the erythropoietin group than in the placebo group (0.86 vs. 0.67; relative risk, 1.26; 95% CI, 1.01 to 1.57). CONCLUSIONS: The administration of erythropoietin to newborns undergoing therapeutic hypothermia for hypoxic-ischemic encephalopathy did not result in a lower risk of death or neurodevelopmental impairment than placebo and was associated with a higher ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt2791q8zw; https://escholarship.org/uc/item/2791q8zw; https://escholarship.org/content/qt2791q8zw/qt2791q8zw.pdf |
| DOI: |
10.1056/nejmoa2119660 |
| Availability: |
https://escholarship.org/uc/item/2791q8zw; https://escholarship.org/content/qt2791q8zw/qt2791q8zw.pdf; https://doi.org/10.1056/nejmoa2119660 |
| Rights: |
public |
| Accession Number: |
edsbas.D5A4685E |
| Database: |
BASE |