title: Safety and efficacy of recombinant human erythropoietin treatment of non-motor symptoms in Parkinson's disease.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Wooyoung
authors.initials: W
authors.lastname: Jang
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea.
authors.forename: Jinse
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Shin
authors.affiliation: Department of Neurology, The Catholic University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joong-Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Whan
authors.initials: JW
authors.lastname: Cho
authors.affiliation: Department of Neurology, Chungnam National University Hospital, College of Medicine, Daejeon, Republic of Korea.
authors.forename: Eungseok
authors.initials: E
authors.lastname: Oh
authors.affiliation: Department of Neurology, Seoul Medical Center, Seoul, Republic of Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ki-Wook
authors.initials: KW
authors.lastname: Oh
authors.affiliation: Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea. Electronic address: kimht@hanyang.ac.kr.
authors.forename: Hee-Tae
authors.initials: HT
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D016037:Single-Blind Method; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014326:Tropanes; D014652:Vascular Diseases / Q000188:drug therapy / Q000209:etiology*
chemical_list: D014326:Tropanes; D004921:Erythropoietin; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
keywords: Efficacy; Erythropoietin; Non-motor symptoms; PET; Parkinson's disease; Safety