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Few treatments are available for acute stroke, and new ones are needed urgently. Several drugs thought to help protect neurones from ischaemic injury have been tried, but none have been effective in clinical trials. A study has found that the free radical trapping drug NXY-059, for which earlier trial results had been promising, is also ineffective.
NXY-059 had been shown to improve outcome relative to placebo if given within six hours of the onset of symptoms. A larger, randomised double blind placebo controlled trial set out to confirm these results, examining disability scores at 90 days. Based on 3195 patients from 362 centres across 31 countries who were included in the efficacy analysis, there was no difference in disability score distribution on the modified Rankin scale between 1588 people treated with NXY-059 and the 1607 treated with placebo (P=0.33, odds ratio 0.94, 95% CI 0.83 to 1.06). Mortality and adverse event rates were similar in the two groups.
The authors conclude the earlier promising findings for NXY-059 were a false dawn, perhaps because animal models of acute focal infarction don't sufficiently represent the patient population.They suggest re-evaluating how we look for neuroprotective drugs.drugs.