MAMBO: Measuring ambulation, motor, and behavioral outcomes with post-stroke fluoxetine in Tanzania: Protocol of a phase II clinical trial
| Autor: | Farrah J. Mateen, Lindsay Pothier, Deus Buma, Andre C. Vogel, Seif Sharif Ismail, Faraja Chiwanga, Kigocha Okeng'o |
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| Rok vydání: | 2020 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Context (language use) Walking Motor Activity Tanzania Article Brain Ischemia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Fluoxetine parasitic diseases Humans Medicine 030212 general & internal medicine Stroke biology business.industry Recovery of Function medicine.disease biology.organism_classification Clinical trial Treatment Outcome Neurology Tolerability Physical therapy Female Neurology (clinical) business Stroke recovery Selective Serotonin Reuptake Inhibitors 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | J Neurol Sci |
| ISSN: | 0022-510X |
| Popis: | BACKGROUND: Sub-Saharan Africa has a high stroke incidence and post-stroke morbidity. An inexpensive pharmacological treatment for stroke recovery would be beneficial to patients in the region. Fluoxetine, currently on the World Health Organization Essential Medicines List, holds promise as a treatment for motor recovery after ischemic stroke, but its effectiveness is controversial and untested in this context in Sub-Saharan Africa. AIM: To determine if fluoxetine 20mg by mouth daily, given within 14 days of acute ischemic stroke, and taken for 90 days, is well-tolerated and safe with adequate adherence to justify a future randomized, controlled trial of fluoxetine in the United Republic of Tanzania. METHODS: Open-label, phase II clinical trial enrolling up to 120 patients. Participants will be recruited from the Muhimbili National Hospital in Dar es Salaam, Tanzania, and followed for 90 days. The primary outcomes are: 1) safety, including serum sodium and hepatic enzyme levels, and 2) tolerability, as measured through study case report forms. The secondary outcomes are: 1) change in motor strength, as measured through the Fugl-Meyer Motor Scale, 2) adherence, as measured with electronic pill bottles, and 3) participant depressive symptom burden measured via standard questionnaires. CONCLUSIONS: Expanding the evidence base for fluoxetine for Sub-Saharan African stroke survivors requires testing of its safety, tolerability, and adherence. Compared to prior studies in France and the United Kingdom, the patient characteristics, health infrastructure, and usual care for stroke recovery are substantially different in Tanzania. If fluoxetine shows favorable endpoints, scale up of its use post-stroke is possible. |
| Databáze: | OpenAIRE |
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