[Efficacy and safety of ethylmethylhydroxypyridine succinate in patients with chronic cerebral ischemia]

[The use of Mexidol in patients with mild (moderate) cognitive impairment: results of a meta-analysis]

OBJECTIVE

To conduct a meta-analysis of the effectiveness of Mexidol therapy in patients with chronic brain ischemia (CBI) and cognitive disorders (CD).

MATERIAL AND METHODS

This meta-analysis included the results of studies on the effectiveness of Mexidol in patients with CD measured with Montreal Cognitive Assessment Scale (MoCA). The pooled effect assessment included all publications from independent clinical trials that provided efficacy data on the MoCA scale with a level of detail sufficient for further mathematical analysis. The main result of the meta-analysis was obtained for the final values of the effectiveness indicator in the Mexidol groups compared with the basic therapy groups. Data from 10 prospective randomized trials containing information on the final scores on the MoCA scale after therapy was analyzed.

RESULTS

The meta-analysis of ten prospective clinical studies of the effectiveness of Mexidol against the background of basic therapy in patients with CCI and CD was carried out. The total number of patients taking Mexidol was 482; the comparison group consisted of 455 patients. According to the results of a statistical model of random effects, the effect size was 2.06; 95% confidence interval for the difference in effectiveness between the groups of the study drug and the control groups [0.98; 3.14] (p=0.0002).

CONCLUSION

A statistically significant and clinically significant improvement in the cognitive functions of patients with CBI, was demonstrated after treatment with Mexidol.

[Pharmacotherapy approaches to vascular mild cognitive impairment in patients of different age groups]

The article discusses the possibilities of pharmacotherapy of moderate vascular cognitive impairment in different age groups. The results of a double-blind randomized clinical trial «MEMO» using the antioxidant and antihypoxic drug Mexidol are presented. On the basis of cognitive scales, when using a sequential course of parenteral and oral administration of mexidol, its reliable effectiveness was shown in each of the three analyzed groups: 40-60 years old, 61-75 years old and 76-90 years old. Mexidol showed an optimal safety profile in all age groups.

Neurological Signs of Postcovid Syndrome

The challenge of postcovid syndrome (PCS) is of great interest due to its wide distribution and variety of clinical signs. The main neurological signs of PCS are discussed. Data on the presumptive mechanisms forming PCS are presented. The potential for using the drug Mexidol to treat patients with PCS is addressed.

[Results of an international multicenter, randomized, double-blind, placebo-controlled study assessing the efficacy and safety of sequential therapy with Mexidol and Mexidol FORTE 250 in patients with chronic brain ischemia (MEMO)]

OBJECTIVE

To assess the efficacy and safety of sequential therapy with Mexidol solution for intravenous and intramuscular administration, 50 mg/ml and Mexidol FORTE 250 film-coated tablets, 250 mg in patients with chronic brain ischemia (CBI).

MATERIAL AND METHODS

An international multicenter, randomized, double-blind, placebo-controlled trial, conducted in 15 clinical centers located in Russian Federation and Republic of Uzbekistan, included 318 patients with CBI aged 40 to 90 years. The patients were randomized into 2 groups, the patients of the 1-st group received Mexidol intravenously 500 mg once daily for 14 days, followed by Mexidol FORTE 250 - 250 mg 3 times a day orally for 60 days; patients of the 2-nd group received a placebo in a similar mode. The primary endpoint was the mean value of difference by MoCA scale at the point of completing the therapy comparing to initial value.

RESULTS

According to the results of the assessment of the primary endpoint, statistically significant changes in the MoCA scores at the stage of completion of study were revealed when comparing the dynamics between the 1-st and 2-nd groups (p<0.000001). The lower limit of the 95% confidence interval for the difference in the average of the main efficacy endpoint between the 1-st and 2-nd groups was 1.51, which allows to state a higher efficacy of the use of Mexidol. According to the estimates of secondary endpoints, a statistically significant advantage over placebo at the last visit achieved while evaluation by the following scales and tests: digit symbol substitution test, MFI-20 asthenia assessment scale, Beck anxiety scale, Vane questionnaire, Tinetti scale, SF-36 questionnaire (mental component of health), CGI scale. The comparable nature of the safety profile of Mexidol and Placebo was established.

CONCLUSION

The validity and expediency of the use of Mexidol and Mexidol FORTE 250 in the treatment of patients with CBI has been demonstrated.