Abstract：
BACKGROUND: Erythropoietin (EPO) is a proposed drug for the treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Multiple studies have linked its use, either as a monotherapy or in conjunction with therapeutic hypothermia (TH), with improved neonatal outcomes including death and neurodisability. However, there is also evidence in the literature that raises concerns about its efficacy and safety for the treatment of neonatal encephalopathy (NE).
METHODS: We searched MEDLINE, Cochrane CENTRAL, and Embase for both observational studies and randomized controlled trials (RCTs) investigating the effectiveness of EPO in treating NE. Only studies in which at least 300 U/kg of EPO was used and reported any one of the following outcomes: death, death or neurodisability, and cerebral palsy, were included.
RESULTS: Seven studies with 903 infants with the diagnosis of NE were included in our meta-analysis. EPO did not reduce the risk of death or neurodisability (risk ratio 0.68 [95% confidence interval [CI]: 0.43 to 1.09]) (P = 0.11). Similarly, the risk of cerebral palsy was not reduced by the administration of EPO (risk ratio 0.68 [95% CI: 0.33 to 1.40]) (P = 0.30). The risk of death was also not reduced at any dose of EPO regardless of the use of TH.
CONCLUSIONS: The results of our meta-analysis do not support the use of EPO for the treatment of neonatal encephalopathy. However, future large-scale RCTs are needed to strengthen these findings.
METHODS: We searched MEDLINE, Cochrane CENTRAL, and Embase for both observational studies and randomized controlled trials (RCTs) investigating the effectiveness of EPO in treating NE. Only studies in which at least 300 U/kg of EPO was used and reported any one of the following outcomes: death, death or neurodisability, and cerebral palsy, were included.
RESULTS: Seven studies with 903 infants with the diagnosis of NE were included in our meta-analysis. EPO did not reduce the risk of death or neurodisability (risk ratio 0.68 [95% confidence interval [CI]: 0.43 to 1.09]) (P = 0.11). Similarly, the risk of cerebral palsy was not reduced by the administration of EPO (risk ratio 0.68 [95% CI: 0.33 to 1.40]) (P = 0.30). The risk of death was also not reduced at any dose of EPO regardless of the use of TH.
CONCLUSIONS: The results of our meta-analysis do not support the use of EPO for the treatment of neonatal encephalopathy. However, future large-scale RCTs are needed to strengthen these findings.
摘要：
背景：促红细胞生成素（EPO）是一种用于治疗新生儿缺氧缺血性脑病（HIE）的药物。多项研究将其使用联系起来，作为单一疗法或与治疗性低温（TH）联合使用，改善新生儿结局，包括死亡和神经残疾。然而,文献中也有证据表明其治疗新生儿脑病(NE)的疗效和安全性令人担忧.
方法：我们搜索了MEDLINE，科克伦中部,和Embase用于观察性研究和随机对照试验（RCTs），研究EPO治疗NE的有效性。仅使用至少300U/kgEPO并报告以下任何一种结果的研究：死亡，死亡或神经残疾，和脑瘫,包括在内。
结果：我们的荟萃分析中纳入了7项研究，包含903名诊断为NE的婴儿。EPO没有降低死亡或神经残疾的风险（风险比0.68[95%置信区间[CI]：0.43至1.09]）（P=0.11）。同样，服用EPO并未降低脑瘫的风险(风险比0.68[95%CI:0.33~1.40])(P=0.30).无论使用哪种剂量的EPO，死亡风险也没有降低。
结论：我们的荟萃分析结果不支持使用EPO治疗新生儿脑病。然而,未来需要大规模RCT来加强这些发现.
方法：我们搜索了MEDLINE，科克伦中部,和Embase用于观察性研究和随机对照试验（RCTs），研究EPO治疗NE的有效性。仅使用至少300U/kgEPO并报告以下任何一种结果的研究：死亡，死亡或神经残疾，和脑瘫,包括在内。
结果：我们的荟萃分析中纳入了7项研究，包含903名诊断为NE的婴儿。EPO没有降低死亡或神经残疾的风险（风险比0.68[95%置信区间[CI]：0.43至1.09]）（P=0.11）。同样，服用EPO并未降低脑瘫的风险(风险比0.68[95%CI:0.33~1.40])(P=0.30).无论使用哪种剂量的EPO，死亡风险也没有降低。
结论：我们的荟萃分析结果不支持使用EPO治疗新生儿脑病。然而,未来需要大规模RCT来加强这些发现.
