Recombinant human erythropoietin: Effect on the functional performance of anemic orthopedic patients

Objective: To determine whether rapid correction of anemia improves the functional and cognitive performance of postoperative orthopedic patients. Design: A randomized, double-blind, placebo-controlled clinical trial. Setting: A rehabilitation institute. Patients: Persons having orthopedic surgery at least 2 weeks previously, and a hemoglobin concentration < 10g/dL. Interventions: Recombinant human erythropoietin (rH-EPO) or the EPO vehicle for up to 8 weeks. All patients received ferrous sulfate. Measurements: Blood counts were performed at weekly intervals, and functional and cognitive tests at baseline and weeks 4 and 8. Results: In patients receiving vehicle only, hemoglobin levels increased from a mean of 9.0 at baseline to 11.0 at 4 weeks and 11.7 at 8 weeks; corresponding values for rH-EPO were 8.8 (p = NS), 12.6 (p = .02), and 13.5 (p = .01). However, functional improvement in dressing, toileting, and mobility was similar between groups, and the results of neuropsychological tests showed no trends favoring rH-EPO. Conclusions: Although hemoglobin increases more rapidly in anemic orthopedic patients treated with rH-EPO, equally rapid functional improvement occurs in those who receive only iron therapy. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation