PT  - JOURNAL ARTICLE
AU  - Lauria, Giuseppe
AU  - Dalla Bella, Eleonora
AU  - Antonini, Giovanni
AU  - Borghero, Giuseppe
AU  - Capasso, Margherita
AU  - Caponnetto, Claudia
AU  - Chiò, Adriano
AU  - Corbo, Massimo
AU  - Eleopra, Roberto
AU  - Fazio, Raffaella
AU  - Filosto, Massimiliano
AU  - Giannini, Fabio
AU  - Granieri, Enrico
AU  - La Bella, Vincenzo
AU  - Logroscino, Giancarlo
AU  - Mandrioli, Jessica
AU  - Mazzini, Letizia
AU  - Monsurrò, Maria Rosaria
AU  - Mora, Gabriele
AU  - Pietrini, Vladimiro
AU  - Quatrale, Rocco
AU  - Rizzi, Romana
AU  - Salvi, Fabrizio
AU  - Siciliano, Gabriele
AU  - Sorarù, Gianni
AU  - Volanti, Paolo
AU  - Tramacere, Irene
AU  - Filippini, Graziella
TI  - Erythropoietin in amyotrophic lateral sclerosis: a multicentre, randomised, double blind, placebo controlled, phase III study
AID  - 10.1136/jnnp-2014-308996
DP  - 2015 Aug 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 879--886
VI  - 86
IP  - 8
4099  - http://jnnp.bmj.com/content/86/8/879.short
4100  - http://jnnp.bmj.com/content/86/8/879.full
SO  - J Neurol Neurosurg Psychiatry2015 Aug 01; 86
AB  - Objective To assess the efficacy of recombinant human erythropoietin (rhEPO) in amyotrophic lateral sclerosis (ALS).Methods Patients with probable laboratory-supported, probable or definite ALS were enrolled by 25 Italian centres and randomly assigned (1:1) to receive intravenous rhEPO 40 000 IU or placebo fortnightly as add-on treatment to riluzole 100 mg daily for 12 months. The primary composite outcome was survival, tracheotomy or >23 h non-invasive ventilation (NIV). Secondary outcomes were ALSFRS-R, slow vital capacity (sVC) and quality of life (ALSAQ-40) decline. Tolerability was evaluated analysing adverse events (AEs) causing withdrawal. The randomisation sequence was computer-generated by blocks, stratified by centre, disease severity (ALSFRS-R cut-off score of 33) and onset (spinal or bulbar). The main outcome analysis was performed in all randomised patients and by intention-to-treat for the entire population and patients stratified by severity and onset. The study is registered, EudraCT 2009-016066-91.Results We randomly assigned 208 patients, of whom 5 (1 rhEPO and 4 placebo) withdrew consent and 3 (placebo) became ineligible (retinal thrombosis, respiratory insufficiency, SOD1 mutation) before receiving treatment; 103 receiving rhEPO and 97 placebo were eligible for analysis. At 12 months, the annualised rate of death (rhEPO 0.11, 95% CI 0.06 to 0.20; placebo: 0.08, CI 0.04 to 0.17), tracheotomy or >23 h NIV (rhEPO 0.16, CI 0.10 to 0.27; placebo 0.18, CI 0.11 to 0.30) did not differ between groups, also after stratification by onset and ALSFRS-R at baseline. Withdrawal due to AE was 16.5% in rhEPO and 8.3% in placebo. No differences were found for secondary outcomes.Conclusions RhEPO 40 000 IU fortnightly did not change the course of ALS.