Erythropoietin for the Repair of Cerebral Injury in Very Preterm Infants

BACKGROUND: Preterm infants suffering from intraventricular hemorrhage (IVH) are at increased risk for neurodevelopmental impairment. Observational data suggest that recombinant human erythropoietin (rEPO) improves long-term cognitive outcome in infants with IVH. Recent studies revealed a beneficial effect of early high-dose rEPO on white matter development in preterm infants determined by magnetic resonance imaging (MRI). OBJECTIVES: To summarize the current evidence and to delineate the study protocol of the EpoRepair trial (Erythropoietin for the Repair of Cerebral Injury in Very Preterm Infants). METHODS: The study involves a review of the literature and the design of a doubleblind, placebo-controlled, multicenter trial of repetitive high-dose rEPO administration, enrolling 120 very preterm infants with moderate-to-severe IVH diagnosed by cranial ultrasound in the first days of life, qualitative and quantitative MRI at term-equivalent age and long-term neurodevelopmental followup until 5 years of age. RESULTS AND CONCLUSIONS: The hypothesis generated by observational data that rEPO may improve long-term cognitive outcomes of preterm infants suffering from IVH are to be confirmed or refuted by the randomized controlled trial, EpoRepair. DOI: https://doi.org/10.1159/000437248 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-117662 Published Version Originally published at: Rüegger, Christoph M; Hagmann, Cornelia F; Bührer, Christoph; Held, Leonhard; Bucher, Hans Ulrich; Wellmann, Sven (2015). Erythropoietin for the Repair of Cerebral Injury in Very Preterm Infants (EpoRepair) : a randomized controlled trial : background, aims, and study protocol. Neonatology, 108(3):198-204. DOI: https://doi.org/10.1159/000437248