Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up
This study is designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to mechanical thrombectomy (MT) in reducing global disability in subjects with acute ischemic stroke (AIS). We have planned a single center, prospective, open-label, single-arm study with a 12-month follo...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.910697/full |
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| author | Jacek Staszewski Adam Stȩpień Renata Piusińska-Macoch Aleksander Dȩbiec Katarzyna Gniadek-Olejniczak Emilia Frankowska Artur Maliborski Zoltan Chadaide David Balo Beata Król Rafael Namias George Harston Józef Mróz Piotr Piasecki |
| author_facet | Jacek Staszewski Adam Stȩpień Renata Piusińska-Macoch Aleksander Dȩbiec Katarzyna Gniadek-Olejniczak Emilia Frankowska Artur Maliborski Zoltan Chadaide David Balo Beata Król Rafael Namias George Harston Józef Mróz Piotr Piasecki |
| author_sort | Jacek Staszewski |
| collection | DOAJ |
| description | This study is designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to mechanical thrombectomy (MT) in reducing global disability in subjects with acute ischemic stroke (AIS). We have planned a single center, prospective, open-label, single-arm study with a 12-month follow-up of 50 patients with moderate to severe AIS, with a small established infarct core and with good collateral circulation who achieve significant reperfusion following MT and who receive additional Cerebrolysin within 8 h of stroke onset compared to 50 historical controls treated with MT alone, matched for age, clinical severity, occlusion location, baseline perfusion lesion volume, onset to reperfusion time, and use of iv thrombolytic therapy. The primary outcome measure will be the overall proportion of subjects receiving Cerebrolysin compared to the control group experiencing a favorable functional outcome (by modified Rankin Scale 0–2) at 90 days, following stroke onset. The secondary objectives are to determine the efficacy of Cerebrolysin as compared to the control group in reducing the risk of symptomatic secondary hemorrhagic transformation, improving neurological outcomes (NIHSS 0–2 at day 7, day 30, and 90), reducing mortality rates (over the 90-day and 12 months study period), and improving: activities of daily living (by Barthel Index), health-related quality of life (EQ-5D-5L) assessed at day 30, 90, and at 12 months. The other measures of efficacy in the Cerebrolysin group will include: assessment of final stroke volume and penumbral salvage (measured by CT/CTP at 30 days) and its change compared to baseline volume, changes over time in language function (by the 15-item Boston Naming Test), hemispatial neglect (by line bisection test), global cognitive function (by The Montreal Cognitive Assessment), and depression (by Hamilton Depression Rating Scale) between day 30 and day 90 assessments). The patients will receive 30 ml of Cerebrolysin within 8 h of AIS stroke onset and continue treatment once daily until day 21 (first cycle) and they will receive a second cycle of treatment (30 ml/d for 21 days given in the Outpatient Department or Neurorehabilitation Clinic) from day 69 to 90. |
| first_indexed | 2024-04-13T12:35:47Z |
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| id | doaj.art-cb5614f1ed524780acfd6ba7f59b4780 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T12:35:47Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-cb5614f1ed524780acfd6ba7f59b47802022-12-22T02:46:40ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-07-011310.3389/fneur.2022.910697910697Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-UpJacek Staszewski0Adam Stȩpień1Renata Piusińska-Macoch2Aleksander Dȩbiec3Katarzyna Gniadek-Olejniczak4Emilia Frankowska5Artur Maliborski6Zoltan Chadaide7David Balo8Beata Król9Rafael Namias10George Harston11Józef Mróz12Piotr Piasecki13Clinic of Neurology, Military Institute of Medicine, Warsaw, PolandClinic of Neurology, Military Institute of Medicine, Warsaw, PolandClinic of Neurology, Military Institute of Medicine, Warsaw, PolandClinic of Neurology, Military Institute of Medicine, Warsaw, PolandNeurorehabilitation Clinic, Military Institute of Medicine, Warsaw, PolandDepartment of Radiology, Military Institute of Medicine, Warsaw, PolandDepartment of Radiology, Military Institute of Medicine, Warsaw, PolandBrainomix Ltd., and Oxford University Hospitals NHSFT, Oxford, United KingdomBrainomix Ltd., and Oxford University Hospitals NHSFT, Oxford, United KingdomBrainomix Ltd., and Oxford University Hospitals NHSFT, Oxford, United KingdomBrainomix Ltd., and Oxford University Hospitals NHSFT, Oxford, United KingdomBrainomix Ltd., and Oxford University Hospitals NHSFT, Oxford, United KingdomNeurorehabilitation Clinic, Military Institute of Medicine, Warsaw, PolandDepartment of Radiology, Military Institute of Medicine, Warsaw, PolandThis study is designed to determine the efficacy of Cerebrolysin treatment as an add-on therapy to mechanical thrombectomy (MT) in reducing global disability in subjects with acute ischemic stroke (AIS). We have planned a single center, prospective, open-label, single-arm study with a 12-month follow-up of 50 patients with moderate to severe AIS, with a small established infarct core and with good collateral circulation who achieve significant reperfusion following MT and who receive additional Cerebrolysin within 8 h of stroke onset compared to 50 historical controls treated with MT alone, matched for age, clinical severity, occlusion location, baseline perfusion lesion volume, onset to reperfusion time, and use of iv thrombolytic therapy. The primary outcome measure will be the overall proportion of subjects receiving Cerebrolysin compared to the control group experiencing a favorable functional outcome (by modified Rankin Scale 0–2) at 90 days, following stroke onset. The secondary objectives are to determine the efficacy of Cerebrolysin as compared to the control group in reducing the risk of symptomatic secondary hemorrhagic transformation, improving neurological outcomes (NIHSS 0–2 at day 7, day 30, and 90), reducing mortality rates (over the 90-day and 12 months study period), and improving: activities of daily living (by Barthel Index), health-related quality of life (EQ-5D-5L) assessed at day 30, 90, and at 12 months. The other measures of efficacy in the Cerebrolysin group will include: assessment of final stroke volume and penumbral salvage (measured by CT/CTP at 30 days) and its change compared to baseline volume, changes over time in language function (by the 15-item Boston Naming Test), hemispatial neglect (by line bisection test), global cognitive function (by The Montreal Cognitive Assessment), and depression (by Hamilton Depression Rating Scale) between day 30 and day 90 assessments). The patients will receive 30 ml of Cerebrolysin within 8 h of AIS stroke onset and continue treatment once daily until day 21 (first cycle) and they will receive a second cycle of treatment (30 ml/d for 21 days given in the Outpatient Department or Neurorehabilitation Clinic) from day 69 to 90.https://www.frontiersin.org/articles/10.3389/fneur.2022.910697/fullCerebrolysinadd-on therapymechanical thrombectomyischemic strokecytoprotection |
| spellingShingle | Jacek Staszewski Adam Stȩpień Renata Piusińska-Macoch Aleksander Dȩbiec Katarzyna Gniadek-Olejniczak Emilia Frankowska Artur Maliborski Zoltan Chadaide David Balo Beata Król Rafael Namias George Harston Józef Mróz Piotr Piasecki Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up Frontiers in Neurology Cerebrolysin add-on therapy mechanical thrombectomy ischemic stroke cytoprotection |
| title | Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up |
| title_full | Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up |
| title_fullStr | Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up |
| title_full_unstemmed | Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up |
| title_short | Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients With Acute Ischemic Stroke Due to Large Vessel Occlusion: Study Protocol for a Prospective, Open Label, Single-Center Study With 12 Months of Follow-Up |
| title_sort | efficacy of cerebrolysin treatment as an add on therapy to mechanical thrombectomy in patients with acute ischemic stroke due to large vessel occlusion study protocol for a prospective open label single center study with 12 months of follow up |
| topic | Cerebrolysin add-on therapy mechanical thrombectomy ischemic stroke cytoprotection |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.910697/full |
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