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Cerebrolysin Offers Benefit To Patients With Right Brain Acute Ischemic Stroke: Presented at DG DISPATCH - ISC

By Cameron Johnston

Special to DG News

FT. LAUDERDALE, FL -- February 16, 2001 -- The neuro-protectant, cerebrolysin, has been shown to be clinically safe and effective in preventing long-term damage from acute ischemic stroke.

Perhaps more important, people whose strokes are in the right hemisphere of the brain seemed to show significant improvements in cognitive function and in activities of daily living when treated with cerebrolysin for a period of 21 days post-stroke.

These findings were presented yesterday (Feb. 15) at the annual International Stroke Conference of the American Stroke Association, by Dr. Gunther Ladurner, a neurologist at the Christian-Doppler Clinic, in Salzburg, Austria, and lead investigator for the Cerebrolysin Study group.

The patients all experienced a first ischemic stroke of the middle cerebral artery. Upon admission to hospital, they were treated with either placebo (n=68) or 50 mg/day of intravenous cerebrolysin for 21 days (n=78). They were then followed for a further 90 days.

At the end of the 21-day period, patients receiving cerebrolysin showed a significant advantage in motor functions and on the Barthel Index over the placebo group, and those who were treated within six hours also showed significantly better clinical global impression scores.

The results were even more favorable in the sub-group of patients whose infarct occurred in the right hemisphere. Those subjects showed significantly better scores on the Canadian Neurological Scale at 21 days, and a trend toward higher scores at 90 days. The clinical global impression scores were also significantly better at 21 days, and there was a trend toward better scores at 90 days.

These findings may indicate that the beneficial effect may wear off eventually.

Nonetheless, the subjects also showed significantly better scores on the mini mental state exam (MMSE) which did not deteriorate within the 90-day follow-up period.

There were three deaths in the placebo group and two in the cerebrolysin group.

Since this was the first human study of the drug in the treatment of acute ischemic stroke, Dr. Ladurner said there is still much to learn about dosing. The 21-day regimen was chosen, he said, because it was based on the favorable results seen in animal studies, but different regimens might well produce different results and more favorable outcomes, he said.

Overall, the drug was well-tolerated and offered patients, especially those with right brain infarctions, significant improvements, some of which were seen as long as 90 days post-event.

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