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Future of neuroprotection for acute stroke: In the aftermath of the SAINT trials
Author(s) -
Savitz Sean I.,
Fisher Marc
Publication year - 2007
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21127
Subject(s) - neuroprotection , medicine , clinical trial , stroke (engine) , acute stroke , intensive care medicine , pharmacology , tissue plasminogen activator , mechanical engineering , engineering
The concept of neuroprotective therapy for acute ischemic stroke to salvage tissue at risk and improve functional outcome is based on sound scientific principles and extensive preclinical animal studies demonstrating efficacy. The failure of most neuroprotective drugs in clinical trials has been due to inadequate preclinical testing and flawed clinical development programs. The Stroke Therapy Academic Industry Roundtable (STAIR) group has outlined rational approaches to preclinical and clinical studies. The positive results from the first Stroke‐Acute‐Ischaemic‐NXY‐Treatment (SAINT‐I) trial of the free‐radical spin‐trap drug, NXY‐059, which followed many of the STAIR guidelines, reinvigorated enthusiasm in neuroprotection, but the SAINT‐II trial did not replicate the positive effect on the same primary prespecified outcome measure. This has led to concerns about the future of neuroprotection as a therapeutic strategy for acute ischemic stroke. We discuss new suggestions to bridge the chasm between preclinical animal modeling and acute human stroke trials to potentially enhance the future assessment of novel neuroprotective drugs. Ann Neurol 2007