title: Erythropoietin for acute multiple sclerosis in patients with optic neuritis as a first demyelination event.
abstract: OBJECTIVE
  To investigate the safety, tolerability, and short-term efficacy of treatment with erythropoietin in patients with optic neuritis as a first demyelination event.
  
  
  METHODS
  We conducted this randomized double-blind pilot study in the Shiraz University of Medical Sciences, Shiraz, Iran, from March 2007 to January 2009. The participants were patients aged 18-45 years with optic neuritis and at least 3 hyperintense lesions on T2-weighted and FLAIR MRI, but no clinically definite multiple sclerosis (MS). They were randomized into 2 groups. The case group (5 patients) received intravenous methyl prednisolone (1000 mg/24 hours) and intravenous erythropoietin (20,000 unit/24 hours) for 5 consecutive days, and the control group (5 patients) received intravenous methyl prednisolone at the same dose as the case group, and a placebo. The groups were followed for one year and compared for adherence to protocol, adverse drug effects, mean duration of conversion to clinically definite MS, and MRI changes.
  
  
  RESULTS
  All patients tolerated the protocol. One patient who received erythropoietin developed cerebral venous sinus thrombosis and anti-cardiolipin antibody positivity. One patient in the control group, but no patients in the case group, fulfilled the McDonald criteria for MS during the follow-up period, but none of the participants in either group developed clinically definite MS according to the Poser criteria.
  
  
  CONCLUSIONS
  Erythropoietin may be effective, but should be used with caution.
authors.affiliation: Department of Neurology, Motahhari Clinic, Namazi Square, Shiraz, Iran. borhanihaghighi@yahoo.com
authors.forename: Afshin
authors.initials: A
authors.lastname: Borhani-Haghighi
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghodsi
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Razeghinejad
authors.forename: Samira
authors.initials: S
authors.lastname: Mardani
authors.forename: Mohsen
authors.initials: M
authors.lastname: Mardani
authors.forename: Ali R
authors.initials: AR
authors.lastname: Nikseresht
authors.forename: Anahid
authors.initials: A
authors.lastname: Safari
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Bagheri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003711:Demyelinating Diseases / Q000188:drug therapy* / Q000473:pathology; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000473:pathology; D009902:Optic Neuritis / Q000188:drug therapy* / Q000473:pathology; D010865:Pilot Projects; D011239:Prednisolone / Q000008:administration & dosage; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D004921:Erythropoietin; D011239:Prednisolone