Abstract
The use of recombinant human erythropoietin (rHuEPO) has been found to improve different cardiopulmonary-related variables that ultimately enhance endurance performance. The main goal of this systematic review was to analyze the hematological, physiological, and performance effects (both maximal and submaximal) of rHuEPO in well-trained endurance athletes. A literature search was conducted in three different databases (PubMed, Web of Science, and Scopus) on 20 January 2025; including studies published from 1 January 2010 to the search date. After analyzing 985 resultant articles and 5 records identified outside of the databases through citation tracking, 10 studies that met the inclusion criteria were included in the systematic review. We found that, regardless of the total dose of rHuEPO used, this substance improves the main hematological (total hemoglobin mass, hemoglobin concentration, and hematocrit) and physiological (maximal oxygen uptake and peak oxygen uptake) parameters, while the maximal performance-related parameters (mainly, maximal power output, and peak power output) also tend to increase. However, further research is needed to determine if rHuEPO can also improve submaximal parameters, which are also major determinants of performance in endurance sports.