ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Monday, February 10, 1997 TAG: 9702100134
SECTION: NATIONAL/INTERNATIONAL PAGE: A-4 EDITION: METRO
DATELINE: ANAHEIM, CALIF.
SOURCE: Associated Press
THE MEDICINE, which shields the brain from a destructive chain reaction, may help patients recover more quickly.
An experimental drug intended to protect the brain after a stroke appears to improve patients' intellectual powers during rehabilitation.
The medicine, called citicoline, is one of a group of new drugs under development for stroke, a devastating disease for which until recently there has been no treatment.
Last June, the Food and Drug Administration approved the use of TPA, the widely used heart attack medicine, for stroke victims. If taken promptly, it can dissolve clots that are lodged in the head and prevent the death of brain cells.
Now doctors are talking about combining TPA with a mixture of so-called neuroprotective drugs such as citicoline that will shield the brain from a destructive chain reaction started by the stroke. Reports on several of these drugs were presented at the 22nd International Joint Conference on Stroke and Cerebral Circulation, which concludes today.
``Last year, for the first time, we had a treatment that works,'' said Dr. Marc Mayberg of the University of Washington. ``Now we are having an explosion. A lot of treatments seem to be working. There will be some dramatic advances in the next three to five years.''
Strokes are the third leading cause of death in the United States. They strike about 500,000 people annually and kill about one-third. Often the survivors are left paralyzed and unable to talk, among other problems.
Most strokes occur when a blood clot gets stuck in an artery in the brain, choking off the supply of oxygen. Patients tend to worsen in the days after a stroke because the breakdown of dying brain cells releases chemicals that harm surrounding tissue.
Citicoline prevents these toxic substances, called free fatty acids, from accumulating. It also provides building materials that nerve cells need to repair themselves.
The latest data, presented by Dr. Creed Pettigrew of the University of Kentucky, were drawn from a study in which 259 stroke victims were randomly assigned to get citicoline or dummy medicines.
During six weeks of treatment, the doctors administered tests to measure intellectual abilities including concentration, memory and attention span. The citicoline patients scored 20 percent to 30 percent better.
``We are pleased with what we saw,'' Pettigrew said. ``It should be very beneficial in helping people recover from their strokes more quickly.''
The drug's maker, Interneuron Pharmaceuticals, plans to seek FDA approval for the medicine by the end of this year. The medicine has been available in Europe for many years for treatment of brain injuries.
Results from studies of another neuroprotective drug, lubeluzole, were less clear-cut. Two studies were conducted - one in North America, and one in Europe and Australia.
Neither showed that the medicine reduced the death rate from stroke, as doctors had hoped. However, in the North American study, the medicine modestly reduced the severity of stroke, while in the other study it did not.
Dr. H.C. Diener of the University of Essen in Germany speculated that patients in the European study were older and had worse strokes, which made them less likely to be helped.
``It's the old 10-ton truck rule,'' added Dr. James Grotta of the University of Texas in Houston. ``When you have a terrible stroke, there is not much chance that you can be helped.''
Johnson & Johnson's Janssen Pharmaceutica subsidiary, which makes lubeluzole, is sponsoring another study of 1,500 stroke patients to try to settle whether it works.
Researchers at the meeting reported that a study of another drug, Ciba-Geigy Corp.'s selfotel, was stopped early because there was no evidence that patients were being helped.
LENGTH: Medium: 75 linesby CNB