Erythropoietin for acute multiple sclerosis in patients with optic neuritis as a first demyelination event

• Published in: Neurosciences (Riyadh, Saudi Arabia) Vol. 17; no. 2; pp. 151 - 155
• Main Authors: Borhani-Haghighi, Afshin, Ghodsi, Maryam, Razeghinejad, Mohammad R, Mardani, Samira, Mardani, Mohsen, Nikseresht, Ali R, Safari, Anahid, Bagheri, Mohammad H
• Format: Journal Article
• Language: English
• Published: Saudi Arabia 01-04-2012
• Subjects: Acute Disease; Adolescent; Adult; Demyelinating Diseases - drug therapy; Demyelinating Diseases - pathology; Drug Therapy, Combination; Erythropoietin - administration & dosage; Erythropoietin - adverse effects; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Humans; Magnetic Resonance Imaging; Middle Aged; Multiple Sclerosis - drug therapy; Multiple Sclerosis - pathology; Optic Neuritis - drug therapy; Optic Neuritis - pathology; Pilot Projects; Prednisolone - administration & dosage; Severity of Illness Index; Treatment Outcome; Young Adult
• ISSN: 1319-6138

To investigate the safety, tolerability, and short-term efficacy of treatment with erythropoietin in patients with optic neuritis as a first demyelination event.
We conducted this randomized double-blind pilot study in the Shiraz University of Medical Sciences, Shiraz, Iran, from March 2007 to January 2009. The participants were patients aged 18-45 years with optic neuritis and at least 3 hyperintense lesions on T2-weighted and FLAIR MRI, but no clinically definite multiple sclerosis (MS). They were randomized into 2 groups. The case group (5 patients) received intravenous methyl prednisolone (1000 mg/24 hours) and intravenous erythropoietin (20,000 unit/24 hours) for 5 consecutive days, and the control group (5 patients) received intravenous methyl prednisolone at the same dose as the case group, and a placebo. The groups were followed for one year and compared for adherence to protocol, adverse drug effects, mean duration of conversion to clinically definite MS, and MRI changes.
All patients tolerated the protocol. One patient who received erythropoietin developed cerebral venous sinus thrombosis and anti-cardiolipin antibody positivity. One patient in the control group, but no patients in the case group, fulfilled the McDonald criteria for MS during the follow-up period, but none of the participants in either group developed clinically definite MS according to the Poser criteria.
Erythropoietin may be effective, but should be used with caution.