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Safety, Pharmacokinetics and Pharmacodynamics of TNHH, a Novel Targeted Neutrophil-Inhibitory Hirulog Hybrid Glycoprotein, in Healthy Volunteers
ConclusionTNHH was well-tolerated following IV infusion. The pharmacokinetic and pharmacodynamic characteristics of TNHH indicate that it merits clinical trials. It is recommended that the single dose of TNHH should be 1.0  mg/kg in future studies, and the expected effect may be achieved after 5–7 days of continuous administration.Trial RegistrationThe study is registered athttp://www.chictr.org.cn as ChiCTR-TQR-14004752.
Source: CNS Drugs - May 14, 2019 Category: Neurology Source Type: research

Tranexamic Acid in Cerebral Hemorrhage: A Meta-Analysis and Systematic Review
ConclusionsTreatment with tranexamic acid could reduce rebleeding and hematoma expansion in cerebral hemorrhage without an increase in single ischemic adverse events, but it could increase the risk of combined ischemic events; however, the lack of improvement in mortality and the poor functional outcomes limit the value of clinical application. These findings indicate that the most pertinent issue is the risk-to-benefit ratio with tranexamic acid treatment in cerebral hemorrhage.
Source: CNS Drugs - February 11, 2019 Category: Neurology Source Type: research

Combination Therapy with Dipyridamole and Clopidogrel for Secondary Stroke Prevention in Aspirin-Intolerant Patients After Myocardial Infarction: Results of a Nationwide Case-Control Study
ConclusionNo differences were observed in the 12-year survival rate between clopidogrel and clopidogrel –dipyridamole groups. The two groups had balanced event-free survival in recurrent stroke, ICH, GI bleeding, and myocardial infarction.
Source: CNS Drugs - January 16, 2019 Category: Neurology Source Type: research

Potential Role of Selective Serotonin Reuptake Inhibitors in Improving Functional Outcome after Stroke
AbstractThe great advances in acute stroke treatment during the last decades have changed life after stroke considerably. However, the use of intravenous thrombolysis and endovascular thrombectomy is limited by a relatively narrow time window or contraindications for treatment. Further, patients receiving acute reperfusion therapies may still have cognitive and emotional complications due to underlying brain infarcts even though physical problems may almost disappear. Consequently, stroke is still a frequent cause of adult disability and death worldwide, and an effort to identify additional treatments to enhance recovery, ...
Source: CNS Drugs - September 17, 2018 Category: Neurology Source Type: research

Effect of Statin Intensity on the Risk of Epilepsy After Ischaemic Stroke: Real-World Evidence from Population-Based Health Claims
ConclusionThe post-stroke use of statins after ischaemic stroke was associated with PSE risk reduction in a cDDD-dependent manner. Further clinical studies on the potential applications of statins for PSE prophylaxis, particularly among at-risk patients, are warranted.
Source: CNS Drugs - April 4, 2018 Category: Neurology Source Type: research

Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Alteplase: A Systematic Review of the Available Evidence
ConclusionExperience with idarucizumab administration prior to tissue plasminogen activator treatment in acute ischemic stroke is limited. Initial clinical experience in less severe stroke syndromes and short time windows seems favorable. Larger cohorts are required to confirm safety, including bleeding complications and the risk of thrombosis.
Source: CNS Drugs - August 14, 2017 Category: Neurology Source Type: research

Pharmacotherapy for Vascular Cognitive Impairment
AbstractVascular cognitive impairment (VCI) is the second most common type of dementia after Alzheimer ’s disease (AD). Stroke and cardiovascular risk factors have been linked to both AD and VCI and potentially can affect cognitive function in mid and later life. Various pharmacological agents, including donepezil, galantamine, and memantine, approved for the treatment of AD have shown modest cogni tive benefits in patients with vascular dementia (VaD). However, their functional and global benefits have been inconsistent. Donepezil has shown some cognitive benefit in patients with VaD only, and galantamine has shown some...
Source: CNS Drugs - August 7, 2017 Category: Neurology Source Type: research

Management of Supine Hypertension Complicating Neurogenic Orthostatic Hypotension
AbstractNeurogenic orthostatic hypotension (NOH) can be present in a number of disorders, including synucleinopathies, autoimmune disorders, and various genetic disorders. All are characterized by defective norepinephrine release from sympathetic terminals upon standing, resulting in impaired vasoconstriction. NOH is defined as a drop in systolic blood pressure ≥20 mmHg or diastolic blood pressure ≥10 mmHg, or both, within 3 minutes of standing or head up-tilt at a minimum of 60°. However, approximately 50% of patients have associated supine hypertension, which greatly complicates treatment. Supine hypertension not on...
Source: CNS Drugs - July 12, 2017 Category: Neurology Source Type: research

Statin Adherence and the Risk of Stroke: A Dose-Response Meta-Analysis
ConclusionImproved adherence to statins was associated with a lower risk of stroke, particularly of IS.
Source: CNS Drugs - March 12, 2017 Category: Neurology Source Type: research

Cardiovascular Effects of Stimulant and Non-Stimulant Medication for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of Trials of Methylphenidate, Amphetamines and Atomoxetine
ConclusionsStatistically significant pre –post increases of SBP, DBP and HR were associated with AMP and ATX treatment in children and adolescents with ADHD, while MPH treatment had a statistically significant effect only on SBP in these patients. These increases may be clinically significant for a significant minority of individuals tha t experience larger increases. Since increased BP and HR in general are considered risk factors for cardiovascular morbidity and mortality during adult life, paediatric patients using ADHD medication should be monitored closely and regularly for HR and BP.
Source: CNS Drugs - February 23, 2017 Category: Neurology Source Type: research

Therapeutic Potential of Transdermal Glyceryl Trinitrate in the Management of Acute Stroke
AbstractThe nitric oxide donor, glyceryl trinitrate (GTN), is a candidate treatment for the management of acute stroke with haemodynamic and potential reperfusion and neuroprotective effects. When administered as a transdermal patch during the acute and subacute phases after stroke, GTN was safe, lowered blood pressure, maintained cerebral blood flow, and did not induce cerebral steal or alter functional outcome. However, when given within 6  h of stroke onset, GTN reduced death and dependency (odds ratio 0.52; 95% confidence interval 0.34–0.78), death, disability, cognitive impairment and mood disturbance, and improved...
Source: CNS Drugs - November 20, 2016 Category: Neurology Source Type: research

Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Conclusions Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials. Its effect on overall linguistic level and written language tends to emerge within a short period and declines thereafter.
Source: CNS Drugs - May 27, 2016 Category: Neurology Source Type: research

Novel Thrombolytics for Acute Ischemic Stroke: Challenges and Opportunities
Abstract Progress in finding a better alternative to alteplase has been slow. Tenecteplase and desmoteplase have better pharmacological profiles compared with alteplase, but definite clinical evidence of their superiority is lacking. The two major phase III studies that have tested the efficacy and safety of desmoteplase in ischemic stroke patients have shown neutral results and a promising safety profile, but the trials compared desmoteplase with placebo only in late admitted patients. Future trials should focus on testing novel thrombolytics in the early time window either as the sole acute recanalizing trea...
Source: CNS Drugs - January 21, 2016 Category: Neurology Source Type: research

Therapeutic Potential of Tenecteplase in the Management of Acute Ischemic Stroke
Abstract Given that alteplase has been the only approved thrombolytic agent for acute ischemic stroke for almost two decades, there has been intense interest in more potent and safer agents over the last few years. Tenecteplase is a bioengineered mutation of alteplase with advantageous pharmacodynamics and pharmacokinetics. The superiority of tenecteplase over alteplase has been proven by in vitro and animal studies, and it was approved for use in myocardial infarction more than a decade ago. In patients with acute ischemic stroke, tenecteplase has shown promise in randomized phase II trials and the drug is curre...
Source: CNS Drugs - September 19, 2015 Category: Neurology Source Type: research

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