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Tran L, Alvarez XA, Le HA, Nguyen DA, Le T, Nguyen N, Nguyen T, Nguyen T, Vo T, Tran T, Duong C, Nguyen H, Nguyen S, Nguyen H, Le T, Nguyen M, Nguyen T. Clinical Efficacy of Cerebrolysin and Cerebrolysin plus Nootropics in the Treatment of Patients with Acute Ischemic Stroke in Vietnam. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2022; 21:621-630. [PMID: 34414874 DOI: 10.2174/1871527320666210820091655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/29/2021] [Accepted: 07/11/2021] [Indexed: 01/13/2023]
Abstract
AIMS To investigate the efficacy and safety of Cerebrolysin and Cerebrolysin plus nootropics in the routine treatment of patients with acute ischemic stroke (AIS). BACKGROUND Acute ischemic stroke (AIS) is a leading cause of disability with unmet treatment needs lacking effective drug therapy. Multimodal drugs modulating stroke pathophysiology as Cerebrolysin constitute a good therapeutic option. OBJECTIVE In this study, we assessed the effects of Cerebrolysin and Cerebrolysin plus nootropics, in comparison with other nootropic drugs alone, on functional, neurological and cognitive recovery of patients with AIS in Vietnam. METHODS This non-interventional, controlled, open-label, prospective and multicenter study included 398 AIS patients (234 males) treated with Cerebrolysin (n=190; 20 i.v. infusions of 10 ml), other nootropics (comparator group; n=86), or a combination of both (n=122). The study primary endpoint was the modified Ranking Scale (mRS) score on day 90. Secondary endpoints included study-period change in NIHSS score; percentage of well-recovered (mRS 0-2) patients, the proportion of good NIHSS response (≥6 points) cases, and MoCA scores at day 90; and safety indicators. RESULTS Compared with other nootropics, both Cerebrolysin and combined therapy induced significant improvements (p<0.001) in: Functional recovery (mRS scores); percentage of well-recovered patients (Cerebrolysin: 81.6%; combination: 93.4%; comparator: 43.0%); neurological recovery (study- period NIHSS change); proportion of good NIHSS responders (Cerebrolysin: 77.5%; combination: 92.5%; comparator: 47.6%); and MoCA scores (Cerebrolysin: 23.3±4.8; combination: 23.7±4.1; comparator: 15.9±7.7). Compared to Cerebrolysin, combined therapy improved (p<0.01) mRS outcomes and NIHSS change, but not MoCA scores, in moderate-severe stroke (NIHSS>11) cases only. No drug-related adverse events were reported. CONCLUSION Cerebrolysin alone or combined with other nootropics was effective and safe in routine AIS treatment, during both acute and recovery phases, which supports its use in daily clinical practice. Others: According to the results of this multicenter study, the importance of reducing differences in the treatment regimens of AIS in Vietnam should be further emphasized.
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Affiliation(s)
- Luc Tran
- Outpatient Department, National Geriatric Hospital, Hanoi, Vietnam
| | - X Anton Alvarez
- Medinova Institute of Neurosciences, Clinica RehaSalud, A Coruña, Spain.,Clinical Research Department, QPS Holdings, A Coruña, Spain
| | | | | | - Thinh Le
- Neurology Department, Bach Mai Hospital, Hanoi, Vietnam
| | - Ngoc Nguyen
- Stroke centre, 108 Military Hospital, Hanoi, Vietnam
| | - Thang Nguyen
- Department of Cerebrovascular Disease, 115 People's Hospital, Hochiminh City, Vietnam
| | - Tai Nguyen
- Neurology Department, Cho Ray Hospital, Hochiminh City, Vietnam
| | - Tan Vo
- Neurology Department, Gia Dinh People's Hospital, Hochiminh City, Vietnam
| | - Tuan Tran
- Neurology Department, Thai Nguyen Central General Hosp, Thainguyen, Vietnam
| | - Chinh Duong
- Neurology Department, Nghe An General Hospital, Nghean, Vietnam
| | - Huyen Nguyen
- Neurology Department, Viet Tiep General Hospital, Haiphong, Vietnam
| | - Sam Nguyen
- Neurology Department, Thanh Hoa General Hospital, Thanhhoa, Vietnam
| | - Hien Nguyen
- Stroke unit, 103 Military Hospital, Hanoi, Vietnam
| | - Thanh Le
- Neurology Department, Thong Nhat Hospital, Hochiminh City, Vietnam
| | - Minh Nguyen
- Neurology Department, Trung Vuong Hospital, Hochiminh City, Vietnam
| | - Thang Nguyen
- Neurology Department, Hochiminh City Medicine and Pharmacy University Hospital, Hochiminh City, Vietnam
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Liang J, Han R, Zhou B. Metabolic Reprogramming: Strategy for Ischemic Stroke Treatment by Ischemic Preconditioning. BIOLOGY 2021; 10:biology10050424. [PMID: 34064579 PMCID: PMC8151271 DOI: 10.3390/biology10050424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 01/15/2023]
Abstract
Stroke is one of the leading causes of death and permanent disability worldwide. Ischemic preconditioning (IPC) is an endogenous protective strategy, which has been reported to exhibit a significant neuroprotective effect in reducing the incidence of ischemic stroke. However, the underlying neuroprotective mechanisms of IPC remain elusive. An increased understanding of the pathogenic mechanisms of stroke and IPC serves to highlight the importance of metabolic reprogramming. In this review, we summarize the metabolic disorder and metabolic plasticity in the incidence and progression of ischemic stroke. We also elaborate how IPC fully mobilizes the metabolic reprogramming to maintain brain metabolic homeostasis, especially for energy and redox homeostasis, and finally protects brain function in the event of an ischemic stroke.
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Affiliation(s)
- Jing Liang
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing 100191, China; (J.L.); (R.H.)
| | - Rongrong Han
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing 100191, China; (J.L.); (R.H.)
| | - Bing Zhou
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing 100191, China; (J.L.); (R.H.)
- School of Engineering Medicine, Beihang University, Beijing 100191, China
- Correspondence:
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