Safety and efficacy of recombinant human erythropoietin treatment of non-motor symptoms in Parkinson's disease

J Neurol Sci. 2014 Feb 15;337(1-2):47-54. doi: 10.1016/j.jns.2013.11.015. Epub 2013 Nov 18.


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.

Keywords: Efficacy; Erythropoietin; Non-motor symptoms; PET; Parkinson's disease; Safety.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain / diagnostic imaging
  • Brain / pathology
  • Cognition Disorders / diagnostic imaging
  • Cognition Disorders / drug therapy
  • Cognition Disorders / etiology
  • Erythropoietin / therapeutic use*
  • Female
  • Humans
  • Male
  • Mental Disorders / drug therapy
  • Mental Disorders / etiology
  • Middle Aged
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology*
  • Positron-Emission Tomography
  • Prospective Studies
  • Single-Blind Method
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / etiology
  • Surveys and Questionnaires
  • Time Factors
  • Tomography, X-Ray Computed
  • Tropanes
  • Vascular Diseases / drug therapy
  • Vascular Diseases / etiology*


  • Tropanes
  • Erythropoietin
  • 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane