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Neurological effects of recombinant human erythropoietin in Friedreich's ataxia: a clinical pilot trial.

Abstract
In a "proof-of-concept" study, we demonstrated that recombinant human erythropoietin (rhuEPO) increases frataxin levels in Friedreich's ataxia (FRDA) patients. We now report a 6-month open-label clinical pilot study of safety and efficacy of rhuEPO treatment in FRDA. Eight adult FRDA patients received 2.000 IU rhuEPO thrice a week subcutaneously. Clinical outcome measures included Ataxia Rating Scales. Frataxin levels and indicators for oxidative stress were assessed. Hematological parameters were monitored biweekly. Scores in Ataxia Rating Scales such as FARS (P = 0.0063) and SARA (P = 0.0045) improved significantly. Frataxin levels increased (P = 0.017) while indicators of oxidative stress such as urine 8-OHdG (P = 0.012) and peroxide levels decreased (P = 0.028). Increases in hematocrit requiring phlebotomies occurred in 4 of 8 patients. In this explorative open-label clinical pilot study, we found an evidence for clinical improvement together with a persistent increase of frataxin levels and a reduction of oxidative stress parameters in patients with FRDA receiving chronic treatment with rhuEPO. Safety monitoring with regular blood cell counts and parameters of iron metabolism is a potential limitation of this approach.
AuthorsSylvia Boesch, Brigitte Sturm, Sascha Hering, Barbara Scheiber-Mojdehkar, Hannes Steinkellner, Hans Goldenberg, Werner Poewe
JournalMovement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 23 Issue 13 Pg. 1940-4 (Oct 15 2008) ISSN: 1531-8257 [Electronic] United States
PMID18759345 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Copyright(c) 2008 Movement Disorder Society.
Chemical References
  • Iron-Binding Proteins
  • Recombinant Proteins
  • Erythropoietin
  • 8-Hydroxy-2'-Deoxyguanosine
  • Deoxyguanosine
Topics
  • 8-Hydroxy-2'-Deoxyguanosine
  • Adult
  • Deoxyguanosine (analogs & derivatives, urine)
  • Enzyme-Linked Immunosorbent Assay (methods)
  • Erythropoietin (therapeutic use)
  • Female
  • Follow-Up Studies
  • Friedreich Ataxia (drug therapy, physiopathology, urine)
  • Humans
  • Iron-Binding Proteins (metabolism)
  • Lymphocytes (metabolism)
  • Male
  • Middle Aged
  • Pilot Projects
  • Recombinant Proteins
  • Severity of Illness Index
  • Treatment Outcome
  • Frataxin

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