Publications (when Stroke)
The Academy of Stroke, Annual Scientific and Educational Forum, traditionally dedicated to World Stroke Day was held in Kyiv October 31 – November 1, 2019.
Yukito Shinohara, Professor Emeritus of Tokai University School of Medicine, former president of the Japan Stroke Society and the Asia Pacific Stroke Organization, Chairman of the Japanese Stroke Guidelines in 2004 and 2009, has held a lecture in Kyiv during the Academy of Stroke 2019. Professor Yukito Shinohara has agreed to give interview to the readers of the International Neurological Journal.
Resume. The article describes the experience of the early use of Xavron (Edaravon) in patients with ischemic stroke in combination with thrombolytic therapy (TLT). These studies indicate greater efficacy of using Edaravon in combination with TLT in the treatment of ischemic stroke. When using the drug Xavron side effects of the drug was not observed.
The purpose of the study is to evaluate the effectiveness of use of the drug edaravone for treatment of patients with acute cerebral infarction comparing to citicoline. The results of the treatment of ischemic stroke by intravenous administration of edaravone (Xavron) and citicoline indicated a more pronounced elimination of neurological deficit in the group edaravone.
Abstract. Ischemic stroke initiates a cascade of biochemical reactions, among which the processes of free radical oxidation occupy a key place. The most important place in management this disease takes reperfusion therapy, the conduct of which is closely related to the problem of neuroprotection. Use of antioxidants is a promising direction for the treatment of ischemic stroke. They have antioxidant effects and could prevent free radical processes. Edaravone is a new low molecular weight free radical scavenger, which inhibits the ischemic cascade. The article provides an overview of studies on the effectiveness and safety of edaravone in patients with ischemic stroke.
From 15 to 16 million people suffer a stroke every year, of which 100-110 thousand are residents of Ukraine. This vascular desiase ranks first among causes of disability and is one of the leading causes of death. One third of patients die during the first year after stroke, one out of four becomes disabled with a violation of basic functions, the daily activity of every second patient is limited, and only one out of five returns to their previous lives. The causes of the catastrophic consequences of a stroke, as well as the possibility of minimizing them, were discussed by the participants of the 11th scientific and practical conference “Neurosymposium”, which was held on September 12-12, 2019 in Odessa.
Neurologist from Japan visits Ukraine for the first time. Dr. Yukito Shinohara is Immediate Past President of the Japan Stroke Society and the Asia Pacific Stroke Organization. He was Chairman of the Japanese Stroke Guidelines in 2004 and 2009. Professor Shinohara gave a presentation on theme “Present Stroke Situation in Japan and Japanese Stroke Guidelines” at the Scientific and Educational Forum “Academy of Stroke 2019”
Abstract. Background. In acute ischemic stroke (AIS), more than 1,000 substances with known neuroprotective effects have been studied, but their effectiveness is considered insufficiently convincing. In 2018, Ukraine launched the release of a new free radical scavenger Xavron (active ingredient — edaravone), which since 2001 has been successfully prescribed in Japan for the treatment of AIS and is a part of the Japanese national guidelines for the treatment of AIS. The purpose of this work is to study the effectiveness of a new neuroprotective drug Xavron (edaravone) in the comprehensive therapy of patients with AIS. Materials and methods. A prospective, integrated clinical, neurological and laboratory examination was conducted in 28 patients (13 women and 15 men) with AIS. The patients were divided into two groups that did not differ in terms of main characteristics and treatment. However, patients in the first group (n = 18) received Xavron (30 mg edaravone) twice daily intravenously. In the control group (n = 10), the drugs with neuroprotective effect were not used. Results. The analysis of Glasgow Coma Scale scores showed a positive dynamics in the majority of patients in both groups without significant statistical difference (p > 0.05). However, the analysis of FOUR (Full Outline of UnResponsiveness) scores showed that in the group where Xavron was used for neuroprotection, since day 5 the level of consciousness was restored more quickly than in the control group. The difference between group 1 and controls became significant within 9–10 days of treatment (p< 0.05). On day 3 in the control group, the level of neuron-specific enolase (NSE) increased by 10 times (from 9.2 to 96.4 ng/ml). Subsequently, there was a rapid decrease in the NSE level, which in the main group of patients was normalized until day 10 of treatment, and in the control group, the NSE level did not reach the reference values within 10 days of therapy (p < 0.05). Conclusions. The use of Xavron (edaravone) in patients with AIS was significantly effective in terms of neurological status (level of consciousness on the FOUR scale) and the dynamics of neurological markers (NSE). Further research is needed to clarify the role of Xavron (edaravone) in the intensive care of AIS patients.
Edaravone, a novel free radical scavenger, demonstrates neuroprotective effects by inhibiting vascular endothelial cell injury and ameliorating neuronal damage in ischemic brain models. The present study was undertaken to verify its therapeutic efficacy following acute ischemic stroke.
We performed a multicenter, randomized, placebo-controlled, double-blind study on acute ischemic stroke patients commencing within 72 h of onset. Edaravone was infused at a dose of 30 mg, twice a day, for 14 days. At discharge within 3 months or at 3 months after onset, the functional outcome was evaluated using the modified Rankin Scale. Two hundred and fifty-two patients were initially enrolled. Of these, 125 were allocated to the edaravone group and 125 to the placebo group for analysis. Two patients were excluded because of subarachnoid hemorrhage and disseminated intravascular coagulation.
A significant improvement in functional outcome was observed in the edaravone group as evaluated by the modified Rankin Scale (p = 0.0382).
Edaravone represents a neuroprotective agent which is potentially useful for treating acute ischemic stroke, since it can exert significant effects on functional outcome as compared with placebo.
Materials of the XXI International Scientific and Practical Conference “Interdisciplinary Issues in Modern Neurology”, April 22-24, Truskavets, Ukraine.
Much attention was paid during the event to the problematic aspects of managing patients with acute ischemic stroke. Within the framework of intensive therapy in cardioneurology a separate scientific symposium discussed the possibilities of modern pharmacotherapy for acute stroke, which are available to doctors today and allow to improve the results of treatment and reduce the disability of patients with stroke.
Background: A free radical scavenger, edaravone, which has been used for the treatment of ischemic stroke, was reported to cause acute kidney injury (AKI) as a fatal adverse event. The aim of the present study was to clarify whether edaravone is associated with AKI in patients with acute ischemic stroke. Methods: From the Fukuoka Stroke Registry database, 5689 consecutive patients with acute ischemic stroke who were hospitalized within 24 hours of the onset of symptoms were included in this study. A logistic regression analysis for the Fukuoka Stroke Registry cohort was done to identify the predictors for AKI. A propensity score–matched nested case–control study was also performed to elucidate any association between AKI and edaravone. Results: Acute kidney injury occurred in 128 of 5689 patients (2.2%) with acute ischemic stroke. A multivariate analysis revealed that the stroke subtype, the basal serum creatinine level, and the presence of infectious complications on admission were each predictors of developing AKI. In contrast, a free radical scavenger, edaravone, reduced the risk of developing AKI (multivariate-adjusted odds ratio [OR] .45, 95% confidence interval [CI] .30-.67). Propensity score–matched case–control study confirmed that edaravone use was negatively associated with AKI (propensity score–adjusted OR .46, 95% CI .29-.74). Conclusions: Although AKI has a significant impact on the clinical outcome of hospital inpatients, edaravone has a protective effect against the development of AKI in patients with acute ischemic stroke.
The scientific-practical conference “Opportunities and Achievements of Modern Pharmacotherapy in the Practice of a Neurologist” held in Kharkov on March 14-15, 2019. It was organized by Association of Neurologists, Psychiatrists and Narcologists of Ukraine, Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine, Kharkiv National University named after V.N. Karazin.
The event was devoted to innovative methods of diagnosis, treatment and prevention of pathologies of central nervous system. Stroke remains a major central nervous system disease due to high prevalence, disability and mortality. You will find an overview of some of the reports voiced at the conference.