Drugs Stop Stroke Damage
15 Hours After Stroke, 1 Drug Halts Damage and Aids Brain Cell Repair
Oct. 24, 2002 -- Two drugs show promise in protecting the brain from injury after a stroke.
The drug currently approved by the FDA for stroke treatment is the clot-buster tissue plasminogen activator (tPA). But only about 2% of stroke patients receive tPA because it must be given within three hours of symptom onset.
In numerous studies, researchers have sought a more effective "neuroprotectant" -- a drug that potentially could stop stroke damage and improve recovery.
However, no neuroprotective drug has looked effective in studies, possibly because most studies have too few patients to show positive results, says Antoni Davalos, MD, PhD, lead researcher of one of the current studies, in a news release. He leads the neurology department at the Hospital Universitari de Girona in Spain.
In this month's issue of Stroke: Journal of the American Heart Association, Davalos and colleagues report that they have found such a drug -- called citicoline.
After reviewing data from four clinical trials of citicoline, they found a pattern not noticed before -- that citicoline was effective in preventing damage during minor strokes. Researchers also found that citicoline prompted the repair of damaged brain cells.
In the four studies, 583 patients received a placebo and 789 were given citicoline an average of 14.5 hours after onset of stroke. Three months later, 25% of the citicoline-treated patients had completely recovered, compared with 20% of the placebo-treated patients. In patients with moderate to severe strokes, six weeks of citicoline treatment increased the odds of complete recovery by 33%, compared with placebo.
"If the results we have obtained are replicated in a large, prospective trial, the neuroprotective drug citicoline may revolutionize the treatment of acute stroke," says Davalos.
The study was funded by Grupo Ferrer of Barcelona, which makes the drug, and Interneuron Pharmaceuticals of Lexington, Mass., which holds the U.S. rights to the drug.
From a Canadian laboratory, there was more good news.
In this week's Science, Canadian researchers report on a promising new drug that, when given to animals, immediately stops brain damage caused by stroke. When administered in rats either before or within one hour after onset of stroke symptoms, the drug stopped the damage that occurs during a stroke.
Thus far, the drug is only known by its chemical name: Tat-NR2B9c.
"To date, we have not encountered any adverse long-term effects of the drug, and all our data show that the drug is more effective in preventing stroke than any method that has ever been used in animals or humans," says study author Michael Tymianski, MD, associate professor of neurosurgery and physiology at the University of Toronto, in a news release.
The drug works by preventing the negative consequences that occur when specific brain receptors are overstimulated during a stroke, he says.
"However, it doesn't block the normal important functions of these receptors, making this a possible practical stroke therapy," says study co-author Michael Salter, MD, a senior scientist at The Hospital for Sick Children in Toronto and professor of physiology at the University of Toronto.
The Canadian study was supported in part by the NIH, the Canadian Stroke Network, the Canadian Institutes of Health Research, and the Heart and Stroke Foundation of Ontario. -->