Drugs to prevent stroke and dementia show promise in early trial

Treatments that prevent recurrence of types of stroke and dementia caused by damage to small blood vessels in the brain have moved a step closer, following a small study. The drugs - called cilostazol and isosorbide mononitrate - are already used to treat other conditions, such as heart disease and angina. This is the first time they have been tested in the UK for the treatment of stroke or vascular dementia.

A study involving more than 50 stroke patients found that patients tolerated the drugs, with no serious side effects, even when the drugs were given in full dose or in combination with other medicines.

Experts say the findings pave the way for larger studies to check if the treatments can prevent brain damage and reduce risk of stroke and vascular dementia.

Damage to small blood vessels in the brain is responsible for around a quarter of strokes. It is also a common cause of memory problems and dementia.

Around 400,000 people in the UK are affected but there are no specific treatments. Currently the only way to reduce risk of the disease is by controlling blood pressure and cholesterol, stopping smoking and managing symptoms of diabetes.

A team led by the Universities of Edinburgh and Nottingham recruited 57 patients who had experienced a stroke caused by damaged small blood vessels, known as a lacunar stroke.

Patients took the two medicines either individually or in combination for up to nine weeks, in addition to usual treatments aimed at preventing further strokes.

They completed health questionnaires and had regular blood pressure checks, blood tests and brain scans.

The findings suggest the drugs are safe for use in stroke patients, taken alone or in combination, at least in the short term.

There were also signs that the treatments helped improve blood vessel function in the arms and brain, and may improve thinking skills, but the researchers stress that further studies are needed to test this. A larger study, called LACI-2, is already underway.

The study, published in EClinicalMedicine, was funded primarily by the Alzheimer's Society, with support from the UK Stroke Association, British Heart Foundation, the European Union, National Institutes of Health Research, and NHS Research Scotland.

Lead researcher Professor Joanna Wardlaw, of the University of Edinburgh's Centre for Clinical Brain Sciences, said: "We are delighted that the results of this trial show promise for treating a common cause of stroke and the commonest cause of vascular dementia, since currently there are no effective treatments. Further trials are underway."

Dr James Pickett, Head of Research at Alzheimer's Society, added: "There hasn't been a new drug for dementia for 15 years, so finding evidence that these cheap existing drugs could prevent dementia after a stroke would be a huge breakthrough. It's promising to see that these two drugs are safe to use and we'll be excited to see the results of the next stage of testing in a couple of years, which will show whether these drugs can be an effective treatment."

Gordon W Blair, Jason P Appleton, Katie Flaherty, Fergus Doubal, Nikola Sprigg, Richard Dooley, Carla Richardson, Iona Hamilton, Zhe Kang Law, Yulu Shi, Michael S Stringer, Michael J Thrippleton, Julia Boyd, Kirsten Shuler, Philip M Bath, Joanna M Wardlaw.
Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: The LACunar Intervention-1 (LACI-1) trial, a randomised clinical trial.
EClinicalMedicine, April 23, 2019. doi: 10.1016/j.eclinm.2019.04.001.

Most Popular Now

AstraZeneca amends collaboration with Ironwood for…

AstraZeneca has amended its collaboration agreement with Ironwood Pharmaceuticals, Inc. (Ironwood) in China mainland, China Hong Kong and China Macau for Linzess (linaclo...

Cause of antibiotic resistance identified

Scientists have confirmed for the first time that bacteria can change form to avoid being detected by antibiotics in the human body. Studying samples from elderly patient...

Bayer, Brigham and Women’s Hospital, and Massachus…

Bayer and Partners HealthCare's founding members Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (MGH) today announced the launch of a joint lab to ...

FDA grants Fast Track designation for Farxiga in h…

AstraZeneca announced that the US Food and Drug Administration (FDA) has granted Fast Track designation for the development of Farxiga (dapagliflozin) to reduce the risk ...

Amgen announces positive results from two Phase 3 …

Amgen (NASDAQ:AMGN) today announced that the results of a prespecified interim analysis of an open-label, randomized, controlled global multicenter Phase 3 trial (2012021...

Brilinta monotherapy in high-bleeding risk patient…

New data from TWILIGHT, a Phase IV independent trial (funded by AstraZeneca), showed that in patients at high-bleeding risk who underwent PCI and completed 3 months of du...

AstraZeneca divests rights for Losec to Cheplaphar…

AstraZeneca has agreed to sell the global commercial rights, excluding China, Japan, the US and Mexico, for Losec (omeprazole) and associated brands to Cheplapharm Arznei...

Educational campaign helps teens and their caregiv…

Teenagers face many challenges, and growing up with a chronic skin disease called atopic dermatitis (AD) can impact the ups and downs and transitions to young adulthood. ...

Gene-targeted cancer drugs, slow release overcome …

Biomedical engineers at Duke University have developed a method to address failures in a promising anti-cancer drug, bringing together tools from genome engineering, prot...

Ian Read to retire as Executive Chairman of Pfizer…

Following its regularly scheduled meeting, the Board of Directors of Pfizer Inc. (NYSE:PFE) today announced that Executive Chairman of the Board Ian C. Read has chosen to...

Novartis and Microsoft announce collaboration to t…

Novartis announced an important step in reimagining medicine by founding the Novartis AI innovation lab and by selecting Microsoft as its strategic AI and data-science pa...

Study points to new drug target in fight against c…

Researchers have identified a potential new drug target in the fight against cancer. In a study this week in the Proceedings of the National Academy of Sciences, an inter...