"If the results we have obtained are replicated in a large prospective trial, the neuroprotective drug, citicoline, may revolutionize the treatment of acute stroke," says the study's senior author Antoni Dvalos, M.D., Ph.D., chairman of the department of neurology at Hospital Universitari de Girona Doctor Josep Trueta in Girona, Spain.

Neuroprotectants are drugs that potentially could stop stroke damage and improve recovery. However, no neuroprotective drug has been effective. That may be because most studies had too few patients to show positive results, Dvalos says. This is the first systemic review to find positive results with a neuroprotective agent.

Dvalos and colleagues performed a meta-analysis of four prospective randomized clinical trials in which six weeks of citicoline treatment was compared to placebo in patients who had suffered an acute ischemic stroke. In a meta-analysis, results of clinical trials are pooled, allowing doctors to see trends that may not be apparent in smaller individual trials. The trials had used three oral doses of citicoline: 500, 1,000 or 2,000 milligrams (mg).

Patient recovery rates at three months were assessed using three standard scales: the Barthel Index, which measures ability to engage in everyday living activities; the Rankin scale, which measures global recovery, and the National Institutes of Health Stroke scale, which measures neurological functioning including a patient's visual capacity, speech and orientation.

Altogether, 583 patients received placebo and 789 were given citicoline. Patients' average age was 68; about half were male; and four-fifths were white. Average time-to-treatment from symptom onset wa
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
24-Oct-2002