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Trifusal Superior to Aspirin for Inhibition of Post-Stroke Inflammatory Markers: Presented at ESC

By Michael J. Worthington

MANNHEIM-HEIDELBERG, GERMANY -- May 18, 2004 -- Trifusal, a fluorinated salicylate agent, appears to be better than aspirin for suppressing post-stroke overexpression of inflammatory mediators, researchers reported here May 14^th at the 13^th European Stroke Conference.

Although the clinical implications of these findings are not known yet, it could mean that trifusal might be more effective than aspirin for preventing post-stroke damage. Dr. J. Alvarez-Sabin and colleagues, Neurovascular Research Laboratory, Hospital d'Hebron, Barcelona, Spain, reported the findings.

"Trifusal has shown neuroprotective effects accompanied by downregulation of nuclear factor kappa-B activation and attenuation of the glial response. But the exact mechanisms whereby trifusal provides neuroprotection are not fully understood," the authors state on their poster. "The ability of trifusal to block cytokines…makes this antiplatelet drug an interesting one for acute stroke treatment."

They enrolled 30 patients with symptoms of acute ischemic stroke (<12 hours) in the middle cerebral artery area and randomized them to treatment with trifusal 900 mg or aspirin (acetylsalicylic acid [ASA] 300 mg. The investigators obtained blood samples at baseline and several time points throughout the study to test several biomarkers of inflammation (e.g. interleukin [IL] 6, IL-8 and IL-10, tumor necrosis factor-alpha, e-selectin, intercellular adhesion molecule -1)

Patients had a mean age of 70 years, 43.3% were male, 23.3% were diabetic, 56.7% had hypertension, 26.7% had a history of atrial fibrillation.

Biomarker assays showed that the maximal concentration of IL-6 was lower in the trifusal group than in the group treated with aspirin (6.1vs. 21.8 pg/mL; P <.001). Patients who received trifusal had lower levels of IL-6 than those who received aspirin at several time points after treatment (i.e. 7.7 vs. 3.9 pg/mL on day 7; P =.04). However, there were no significant differences between groups in the levels of other biomarkers.

Studies need to be done to determine whether these findings translate into clinical benefit, the authors concluded.


[Presentation title: Trifusal is superior to aspirin suppressing the inflammatory response that follows ischemic stroke.]

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