Effect of Lomerizine Hydrochloride on Preventing Strokes in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy
| Autor: | Masaki Kondo, Ikuko Mizuta, Masaru Matsui, Toshiki Mizuno, Isao Yokota, Koushun Matsuo, Keita Ito, Ai Hamano, Kei Yamada, Takashi Koizumi, Masanori Nakagawa, Akihiro Fujii, Akiko Watanabe-Hosomi, Satoshi Teramukai, Mao Mukai |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Hydrochloride CADASIL Pilot Projects Piperazines Leukoencephalopathy chemistry.chemical_compound Secondary Prevention Medicine Humans Pharmacology (medical) In patient Receptor Notch3 Aged Ischemic Stroke Pharmacology Lomerizine business.industry Incidence Middle Aged medicine.disease Magnetic Resonance Imaging chemistry Female Neurology (clinical) business medicine.drug |
| Zdroj: | Clinical neuropharmacology. 43(5) |
| ISSN: | 1537-162X |
| Popis: | Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an orphan disease clinically characterized by migraine, recurrent strokes, and dementia. Currently, there are no disease-modifying therapies, and it is difficult to prevent cerebral ischemic events in CADASIL patients by conventional antithrombotic medication. We hypothesized that an antimigraine agent, lomerizine hydrochloride, may prevent strokes in CADASIL patients, based on its effect on increasing cerebral blood flow.This was an open-labeled clinical trial in which 30 adult CADASIL patients received lomerizine at 10 mg/d. Numbers of symptomatic strokes during the 2 years after the start of lomerizine administration were compared with those in the 2 years before its initiation. The effect of lomerizine on preventing strokes was evaluated based on the incidence rate ratio (IR) calculated with the Mantel-Haenszel method.When including all 30 patients (analysis 1), the IR was less than 1 (0.46; 95% confidence interval [CI], 0.19-1.12) but did not reach significance. To evaluate the effect of lomerizine on secondary prevention, subgroups of 15 patients with stroke episodes occurring any time before lomerizine administration (analysis 2) and 10 patients with stroke episodes during the 2 years before lomerizine administration (analysis 3) were analyzed. The IR values were 0.33 (95% CI, 0.12-0.94) in analysis 2 and 0.17 (95% CI, 0.04-0.67) in analysis 3.Our results suggest the effect of lomerizine on preventing secondary stroke in CADASIL patients. |
| Databáze: | OpenAIRE |
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