High-dose erythropoietin of little benefit to preemies with intraventricular haemorrhage

The use of high-dose erythropoietin in the treatment of preterm infants with intraventricular haemorrhage (IVH) does not appear to produce improvements in neurological outcomes, according to a study.

The study included 121 preterm infants (gestational age <32 weeks or birth weight <1,500 g) with moderate to severe IVH, as confirmed by cerebral ultrasonography, and who were aged ≤8 days. They were randomized to receive intravenous high-dose erythropoietin (2,000 units/kg body weight; n=60, 48 percent boys) or placebo (n=61, 61 percent boys) at four time points between the first and fourth weeks of life.

Infant and maternal characteristics at baseline were comparable in the two treatment groups. The median birth weight was 832 g in the erythropoietin group and 870 g in the placebo group. The median gestation in the respective groups was 26.1 and 27.0 weeks.

The primary endpoint was the composite intelligence quotient at 5 years of age; the data will not be available until 2023. The present analysis assessed the effect of treatment on secondary outcomes including (1) mortality and morbidity rates and (2) brain magnetic resonance imaging findings at term-equivalent age (TEA).

At TEA, there had been 10 deaths recorded in the erythropoietin group and five in the placebo group (16.7 percent vs 8.2 percent; adjusted odds ratio, 2.24, 95 percent confidence interval [CI], 0.74–7.66; p=0.15). Mean haematocrit levels were higher among infants receiving erythropoietin vs placebo.

Among the 100 infants with conventional magnetic resonance imaging at TEA, there were no significant between-group differences seen in global or regional brain injury scores.