Wooyoung Jang1, Jinse Park2, Kyung Jin Shin2, Joong-Seok Kim3, Ji Sun Kim4, Jinyoung Youn5, Jin Whan Cho5, Eungseok Oh6, Jin Young Ahn7, Ki-Wook Oh8, Hee-Tae Kim9. 1. Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea; Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea. 2. Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea. 3. Department of Neurology, The Catholic University College of Medicine, Seoul, Republic of Korea. 4. Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. 5. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Department of Neurology, Chungnam National University Hospital, College of Medicine, Daejeon, Republic of Korea. 7. Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea. 8. Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea. 9. Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea. Electronic address: kimht@hanyang.ac.kr.
Abstract
BACKGROUND: Numerous animal studies and clinical trials have demonstrated that erythropoietin (EPO) has therapeutic effects in ischemic and degenerative diseases. However, few clinical trials have investigated the effect of EPO in Parkinson's disease (PD) patients. This study was an exploratory pilot study to investigate the effects of recombinant human EPO (rhEPO) on motor and non-motor symptoms (NMS) in PD patients. METHODS: A total of 26 PD patients at the Hanyang University Hospital were enrolled in the study. The participants were randomly assigned to rhEPO and placebo groups. The rhEPO group was infused intravenously (40,000 IU each) twice a week for 5 weeks. Clinical improvement was estimated using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III), the NMS Scale (NMSS) and the 39-Item Parkinson's Disease Questionnaire (PDQ-39). [(18)F] N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) photon emission tomography (PET) scanning was performed on each participant at baseline and again after 12 months. RESULTS: The rhEPO administration significantly improved the NMSS and PDQ-39 scores at 12 months. The UPDRS-III, which reflects motor function, did not change significantly after the rhEPO treatment. With the NMSS, the domains of cardiovascular autonomic function, sleep/fatigue, mood/cognition and attention/memory showed significant changes. None of the participants experienced any serious adverse effects. DISCUSSION: We found that rhEPO had beneficial effects on NMS but not on motor function. Dopaminergic refractory NMS, such as cardiovascular autonomic dysfunction and cognition, showed improvement after the administration of rhEPO. Our results suggest that rhEPO might be a good candidate for the treatment of NMS in PD patients.
RCT Entities:
BACKGROUND: Numerous animal studies and clinical trials have demonstrated that erythropoietin (EPO) has therapeutic effects in ischemic and degenerative diseases. However, few clinical trials have investigated the effect of EPO in Parkinson's disease (PD) patients. This study was an exploratory pilot study to investigate the effects of recombinant humanEPO (rhEPO) on motor and non-motor symptoms (NMS) in PDpatients. METHODS: A total of 26 PDpatients at the Hanyang University Hospital were enrolled in the study. The participants were randomly assigned to rhEPO and placebo groups. The rhEPO group was infused intravenously (40,000 IU each) twice a week for 5 weeks. Clinical improvement was estimated using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III), the NMS Scale (NMSS) and the 39-Item Parkinson's Disease Questionnaire (PDQ-39). [(18)F] N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane (FP-CIT) photon emission tomography (PET) scanning was performed on each participant at baseline and again after 12 months. RESULTS: The rhEPO administration significantly improved the NMSS and PDQ-39 scores at 12 months. The UPDRS-III, which reflects motor function, did not change significantly after the rhEPO treatment. With the NMSS, the domains of cardiovascular autonomic function, sleep/fatigue, mood/cognition and attention/memory showed significant changes. None of the participants experienced any serious adverse effects. DISCUSSION: We found that rhEPO had beneficial effects on NMS but not on motor function. Dopaminergic refractory NMS, such as cardiovascular autonomic dysfunction and cognition, showed improvement after the administration of rhEPO. Our results suggest that rhEPO might be a good candidate for the treatment of NMS in PDpatients.
Authors: James L Miller; Timothy J Church; Dmitri Leonoudakis; Karen Lariosa-Willingham; Normand L Frigon; Connie S Tettenborn; Jeffrey R Spencer; Juha Punnonen Journal: Mol Pharmacol Date: 2015-05-27 Impact factor: 4.436