Citicoline News

Citicoline Helpful in Treatment of Acute Stroke
Oct. 30, 2002 - Laurie Barclay, MD

A meta-analysis reported in the November issue of Stroke supports the benefit of citicoline for the treatment of acute stroke.

"Treatment with oral citicoline within the first 24 hours after onset in patients with moderate to severe stroke increases the probability of complete recovery at three months," write Antoni Davalos, MD, PhD, from the Hospital Universitari de Girona Doctor Josep Trueta in Girona, Spain, and colleagues.

A literature database search identified four prospective, randomized, placebo-controlled, double-blind clinical trials with oral citicoline at doses of 500, 1,000, or 2,000 mg. Of 1,652 randomized patients, 1,372 met inclusion criteria of neuroimaging compatible with ischemic stroke, National Institutes of Health Stroke Scale Score of at least 8, and prior modified Rankin Scale score of 1 or less.

Of these 1,372 patients, 789 received citicoline and 583 received placebo. At three months, 25.2% of citicoline-treated patients and 20.2% of placebo-treated patients had recovered (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.10-1.62; P=.0034). The 2,000-mg dose of citicoline conferred the greatest advantage over placebo, with recovery in 27.9% of patients (OR, 1.38; 95% CI, 1.10-1.72; P=.0043). Overall, the safety of citicoline was similar to that of placebo.

"Citicoline is the only putative neuroprotectant that has shown partial positive results in all randomized, double-blind trials," the authors write, noting additional benefits of efficacy when administered within 24 hours rather than within six hours of symptom onset, and relative lack of adverse events. "Although the capacity of citicoline to rescue ischemic tissue may be limited, its safety profile likely provides a favorable risk-to-benefit ratio…. A new trial to confirm these results should be conducted."

Interneuron Pharmaceuticals, Inc., provided the original databases of the clinical trials used in this meta-analysis.

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