A Cochrane review [Abstract] 1 included 11 studies involving 1275 participants. Most trials were small safety studies. The patients were randomized on erythropoietin (EPO) trials within 48 hours after the ischaemic stroke. In 3 trials (n = 782), EPO therapy was associated with a significant increase in death by the end of the trial (OR 1.98, 95% CI 1.19 to 3.3, p = 0.009) and a non-significant increase in serious adverse events. EPO significantly increased the red cell count with no effect on platelet or white cell count, or infarct volume. Eight small trials (n = 548) of granulocyte colony stimulating factor (G-CSF) were included. The patients were randomized on G-CSF within 30 days of ischaemic stroke, so all patients were not acute ischaermic patients. G-CSF was associated with a non-significant reduction in early impairment (MD -0.4, 95% CI -1.82 to 1.01, p = 0.58) but had no effect on functional outcome at the end of the trial. G-CSF significantly elevated the white cell count and the CD34+ cell count, but had no effect on infarct volume.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions).
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