Volume 25, Issue 1 (Avicenna Journal of Clinical Medicine - Spring 2018)
Avicenna J Clin Med 2018, 25(1): 20-27 |
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Mazaheri S, Darvish M, Pooroalajal J, Fariadras M. A Comparative Study on the Effect of Citicoline on Acute Ischemic and Hemorrhagic Stroke. Avicenna J Clin Med 2018; 25 (1) :20-27
URL: http://sjh.umsha.ac.ir/article-1-1694-en.html
URL: http://sjh.umsha.ac.ir/article-1-1694-en.html
1- Associate Professor, Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran , mahsadarvish1362@gmail.com
3- Associate Professor, Department of Epidemiology and Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
4- MSc in Epidemiology, Department of Epidemiology and Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran , mahsadarvish1362@gmail.com
3- Associate Professor, Department of Epidemiology and Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
4- MSc in Epidemiology, Department of Epidemiology and Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract: (25407 Views)
Background and Objective: Evidence is indicative of the positive effect of citicoline administration in stroke patients; however, there are controversies over this issue. Regarding this, the present study was conducted to investigate the efficacy of citicoline in acute stroke patients.
Materials and Methods: This randomized clinical trial was conducted on 160 patients with hemorrhagic and ischemic stroke. The participants were randomly assigned into two groups of intervention and control. The intervention group daily received 1 g citicoline injections for 10 days, in addition to the standard therapy. The baseline severity of the disease was determined by the National Institutes of Health Stroke Scale, and the outcome of the disease was assessed using the Modified Rankin Scale and Barthel Index on the 1st, 10th, and 90th days post-intervention. Statistical analysis was performed using Stata software (version 11.1). P-value less than 0.05 was considered statistically significant.
Results: According to the results, there was no significant difference between the two groups in terms of gender, mean age, hypertension, diabetes, smoking, hyperlipidemia, and mortality after stroke (P>0.05). Regardless of the type of stroke, the severity of the disease decreased over time in both groups. However, at the end of the study (the 90th day), the intervention group had lower disease severity, compared to the control group (P<0.05). In terms of the ischemic stroke patients, the severity of the disease was significantly lower in the intervention group on the 90th day, compared to that in the control group.
Conclusion: Based on the findings of this study, the use of citincoline in acute stroke patients exerted no significant effect in the disease treatment in the short term. However, the long-term administration of this medication could result in significant impacts on the treatment of the patients, especially those with ischemic stroke, and improvement of their efficacy.
Materials and Methods: This randomized clinical trial was conducted on 160 patients with hemorrhagic and ischemic stroke. The participants were randomly assigned into two groups of intervention and control. The intervention group daily received 1 g citicoline injections for 10 days, in addition to the standard therapy. The baseline severity of the disease was determined by the National Institutes of Health Stroke Scale, and the outcome of the disease was assessed using the Modified Rankin Scale and Barthel Index on the 1st, 10th, and 90th days post-intervention. Statistical analysis was performed using Stata software (version 11.1). P-value less than 0.05 was considered statistically significant.
Results: According to the results, there was no significant difference between the two groups in terms of gender, mean age, hypertension, diabetes, smoking, hyperlipidemia, and mortality after stroke (P>0.05). Regardless of the type of stroke, the severity of the disease decreased over time in both groups. However, at the end of the study (the 90th day), the intervention group had lower disease severity, compared to the control group (P<0.05). In terms of the ischemic stroke patients, the severity of the disease was significantly lower in the intervention group on the 90th day, compared to that in the control group.
Conclusion: Based on the findings of this study, the use of citincoline in acute stroke patients exerted no significant effect in the disease treatment in the short term. However, the long-term administration of this medication could result in significant impacts on the treatment of the patients, especially those with ischemic stroke, and improvement of their efficacy.
Type of Study: Original |
References
1. Mukherjee D, Patil CG. Epidemiology and the global burden of stroke. World Neurosurg. 2011;76(6):S85-90. [DOI] [PubMed]
2. Greenberg D, Aminof M, Simon R. Clinical neurology. 8th ed. New York: McGraw Hill; 2012.
3. Abou-Chebl A. Intra-arterial therapy for acute ischemic stroke. Neurotherapeutics. 2011;8(3):400-13.
4. Hajjar K, Kerr DM, Lees KR. Thrombolysis for acute ischemic stroke. J Vasc Surg. 2011;54(3):901-7. [PubMed]
5. Schabitz WR, Li F, Irie K, Sandage BW Jr, Locke KW, Fisher M. Synergistic effects of a combination of low-dose basic fibroblast growth factor and citicoline after temporary experimental focal ischemia. Stroke. 1999;30(2):427-31. [PubMed]
6. Southerland WM. Foundation of medicine biochemistery. New York: Churchil Livingstone; 1990.
7. Boudouresques AB, Michel B. Therapeutic conduct in light of a cerebral vascular accident and the use of CDP-choline. International symposium: brain suffering and precursors of phospholipids, Paris; 1980.
8. Corso EA, Arena M, Ventimiglia A, Bizzarro G, Campo G, Rodolico F. CDP choline in cerebral vasculopathy: clinical evaluation and instrumental semeiology. Clin Ter. 1982;102(4):379-86. [PubMed]
9. Tazaki Y, Sakai F, Otomo E, Kutsuzawa T, Kameyama M, Omae T, et al. Treatment of acute cerebral infarction with a choline precursor in a multicenter double-blind placebo-controlled study. Stroke. 1988;19(2):211-6. [PubMed]
10. Andersen M, Overgaard K, Meden P, Boysen G, Choi SC. Effects of citicoline combined with thrombolytic therapy in a rat embolic stroke model. Stroke. 1999;30(7):1464-71. [PubMed]
11. Rao AM, Hatcher JF, Dempsey RJ. CDP-choline: neuroprotection in transient forebrain ischemia of gerbils. J Neurosci Res. 1999;58(5):697-705. [PubMed]
12. de Campos LM, Martins BM, Cabral NL, Franco SC, Pontes-Neto OM, Mazin SC, et al. How many patients become functionally dependent after a stroke? A 3-year population-based study in Joinville, Brazil. PLoS One. 2017;12(1):e0170204. [DOI] [PubMed]
13. Moderator Lundbye J, Lyden PD, Polderman KH, Schwab S. Clinical studies targeting stroke and ischemic insults. Ther Hypothermia Temp Manag. 2017;7(1):12-5. [DOI]
14. Skalny AV, Klimenko LL, Turna AA, Budanova MN, Baskakov IS, Savostina MS, et al. Serum trace elements are interrelated with hormonal imbalance in men with acute ischemic stroke. J Trace Elem Med Biol. 2017;43:142-7. [DOI] [PubMed]
15. Warburton E, Alawneh JA, Clatworthy PL, Morris RS. Stroke management. BMJ Clin Evid. 2011;2011:0201. [PubMed]
16. Overgaard K, Meden P. Citicoline--the first effective neuroprotectant to be combined with thrombolysis in acute ischemic stroke? J Neurol Sci. 2006;247(2):119-20. [DOI] [PubMed]
17. Sergeev DV, Domashenko MA, Piradov MA. Pharmacological neuroprotection in stroke in clinical practice: new perspectives. Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(4):86-91. [PubMed]
18. Mashin VV, Belova LA, Dudikov EM, Bergelson TM, Lankov VA, Zakuraeva KA. The efficacy of recognan in the early stage of ischemic stroke. Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(10):44-8. [DOI] [PubMed]
19. Saver JL. Citicoline: update on a promising and widely available agent for neuroprotection and neurorepair. Rev Neurol Dis. 2008;5(4):167-77. [PubMed]
20. Ghosh S, Das SK, Nath T, Ghosh KC, Bhattacharyya R, Mondal GP. The effect of citicoline on stroke: A comparative study from the Eastern part of India. Neurol India. 2015;63(5):697-701. [DOI] [PubMed]
21. Casado A, Secades JJ, Ibarz R, Herdman M, Brosa M. Cost-effectiveness of citicoline versus conventional treatment in acute ischemic stroke. Expert Rev Pharmacoecon Outcomes Res. 2008;8(2):151-7. [DOI] [PubMed]
22. Ashrefian H, Tgha M, Vosoghi R, Nikkha K. The effects of citicoline in stroke patients. Mashhad Univ Med Sci. 2002;45(77):59-64. [Persian]
23. Cho HJ, Kim YJ. Efficacy and safety of oral citicoline in acute ischemic stroke: drug surveillance study in 4,191 cases. Methods Find Exp Clin Pharmacol. 2009;31(3):171-6. [DOI] [PubMed]
24. Iranmanesh F, Vakilian A. Efficiency of citicoline in increasing muscular strength of patients with nontraumatic cerebral hemorrhage: a double-blind randomized clinical trial. J Stroke Cerebrovasc Dis. 2008;17(3):153-5. [DOI] [PubMed]
25. Davalos A, Alvarez-Sabin J, Castillo J, Diez-Tejedor E, Ferro J, Martinez-Vila E, et al. Citicoline in the treatment of acute ischaemic stroke: an international, randomised, multicentre, placebo-controlled study (ICTUS trial). Lancet. 2012;380(9839):349-57. [DOI] [PubMed]
26. Alvarez-Sabin J, Ortega G, Jacas C, Santamarina E, Maisterra O, Ribo M, et al. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35(2):146-54. [DOI] [PubMed]
27. Shamalov NA, Stakhovskaia LV, Shetova IM, Efremova NM, Anisimov KV. Efficacy and safety of the combined therapy with citicholine and actovegin in the acute period of ischemic stroke. Zh Nevrol Psikhiatr Im S S Korsakova. 2010;110(9 Pt 2):13-7. [PubMed]
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