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[Comment] EPO in traumatic brain injury: two strikes…but not out?

Despite past failures,1 the promise of clinical neuroprotection in traumatic brain injury continues to drive the assessment of new compounds. The latest of these compounds is erythropoietin, a haemopoietic growth factor from the type 1 cytokine superfamily, which, through several non-haemopoietic mechanisms, has been shown to be neuroprotective in experimental traumatic brain injury.2 In The Lancet, Alistair Nichol and colleagues3 report the results of EPO-TBI, a double-blind, randomised clinical trial of a safety-adaptive dose regimen of erythropoietin (40 000 units subcutaneously once per week for a maximum of three doses) versus placebo, in 606 patients with traumatic brain injury admitted to an intensive care unit, with treatment initiated within 24 h of injury.