Erythropoietin (EPO) is a glycoprotein hormone that primarily controls red blood cell production. Interest in utilizing this pharmaceutical agent to treat acute SCI stems from one of its most commonly studied secondary functions, the prevention of neuronal apoptosis in the presence of ischemia (Siren et al. 2001). Even less well understood, EPO has been shown to elicit anti-inflammatory properties, minimize lipid peroxidation, scavenge free radicals, regenerate axons, and reduce calcium ions and influx of glutamate in in vitro and in vivo animal studies (Matis & Birbilis, 2009). Experimental SCI studies in animal models to date have shown that EPO elicits a neuroprotective benefit that contributes to neurological recovery (Hong et al. 2011; Okutan et al. 2007).
Two studies to date have shown promising results for EPO in treating acute SCI (Alibai et al. 2014; Xiong et al. 2011). It is important to note that these studies have very small sample sizes (n<70); further, study participants were neither blinded nor randomized. Large-scale RCTs are warranted to determine the effectiveness of EPO in treating acute SCI.
There is level 1b evidence (from one RCT and one prospective controlled trial; Alibai et al. 2014; Xiong et al. 2011) that erythropoietin is effective in promoting neurological recovery in acute SCI individuals.
Erythropoietin may be effective for neurological recovery during the acute phase post SCI.