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| Citicoline shows clinical promise for ICH treatment |
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03 March 2006
Spanish researchers have reported the use of citicoline in intracerebral haemorrhage (ICH) patients without serious adverse reactions. Moreover, the results of the pilot study suggested a trend towards improved functional outcome among patients treated with citicoline, compared with those who received placebo.
Citicoline is a neuroprotectant that has beneficial effects in the acute phase of ischemic stroke, Dr Julio Secades (Hospitals de la Vall d'Hebrón, Barcelona) and co-workers explain. As citicoline has also shown efficacy in experimental models of ICH, the team decided to study the effects of the drug in human ICH patients.
Citicoline, at a dose of 1g every 12 hours, was administered to 19 patients within 6 hours of ICH onset, and continued for 2 weeks after the event, while a further 19 patients received placebo. At baseline, the patients assigned to receive placebo and citicoline had comparable Glasgow Coma Scale scores of 13.8 and 13.9, and National Institutes of Health Stroke Scale scores of 13.7 and 10.6, respectively. Four patients from each group suffered adverse events during the study period, none of which were related to the treatment. Two patients in each group died, and one haemorrhage, resulting from re-bleeding of the same ICH, occurred in each group.
After 2 weeks of treatment, four citicoline-treated patients had attained a favourable outcome, with a modified Rankin Scale score of between 0 and 2, compared with just one placebo-treated patient. When assessed after 12 weeks, the number of citicoline-treated patients with a favourable outcome had increased to five, while the number of patients with a favourable outcome in the placebo group remained at one. This translates into a 5.38-fold increase in the likelihood of citicolone-treated patients having a favourable outcome.
"In conclusion, citicoline seems to be a safe drug when used in ICH patients," Dr Secades et al write in the journal Cerebrovascular Diseases. "The efficacy for this condition should be confirmed in a larger clinical trial."
Reference:
Cerebrovasc Dis 2006; 21 (5-6): 380-385.
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