Effect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke a debatable issue.docVIP

Yuen et al. Critical Care 2011, 15:425 /content/15/3/425 LETTER E? ect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke: a debatable issue Chun-Man Yuen , Cheuk-Kwan Sun , Steve Leu and Hon-Kan Yip* 1 2,3 4,5 4,5 See related research by Yip et al., /content/15/1/R40, and related commentary by Minnerup et al., /content/15/2/129 Our recent clinical trial has shown that erythropoietin the trial in our study was prospective, randomized, and (EPO) therapy signi? cantly increased circulating endo- placebo-controlled – this is the best design to minimize thelial progenitor cell (EPC) levels and was strongly the selection bias between the study group and the associated with favorable 90-day clinical outcomes after control group. Accordingly, we suggest that the signi? - ischemic stroke (IS) [1]. Contrary to the ? ndings of our study [1] and of others [2,3], the randomized phase II/III cantly lower number of patients with an NIHSS score of at least 8 in the EPO group in comparison with the German Multicenter EPO Stroke Trial [4], which is placebo group could re? ect simply the therapeutic currently the largest clinical study on EPO treatment in bene? t of EPO therapy in improving the 90-day neuro- patients with IS, not only failed to show any additional logical outcome rather than a mere speculation of a bene? t but also demonstrated increased mortality after combined therapy with EPO and tissue plasminogen activator (tPA) [4]. Interestingly, subgroup analysis of the study revealed that EPO therapy improved 90-day clinical higher rate of recur rent strokes in the placebo group. e optimal dosage of EPO and duration of treatment for patients af