Edaravone - citicoline comparative study in acute ischemic stroke (ECCS-AIS)

Abstract

Background: Two new neuro-protective agents, Edaravone and Citicoline were recently found to be beneficial in acute ischemic stroke (AIS). But there is no study to compare these two agents on same protocol in AIS. This study was aimed to compare these two neuroprotective agents in AIS.

Methods: All patients of age more than 18 years who presented within 24 hours of acute ischemic stroke were randomly treated with Edaravone (group E), Citicoline (group C) or none (group N) with other standard treatment of AIS. Modified Rankin Scale (MRS) and National Institute of Health Stroke Scale (NIHSS) were recorded on admission and at 3 months. Analysis was done using Anova t test to find out significant difference in outcome at 3 months. P value of < or = 0.05 was labeled as significant.

Results: Mean MRS and NIHSS scores at 3 months were lowest in group E (p = 0.000), suggestive of better outcome in this group. After application of severity scale, 15 patients (68.1%) in group-E, 14 (58.3%) in group C and 18 (72%) in group N had moderate to severe stroke (NIHSS of more than 10). When the patients of moderate to severe stroke were analyzed separately at 3 months, patients in group E (mean 4.46 +/- 3.52) had significantly (p = 0.00) better outcome in comparison to group C (mean 10.28 +/- 7.93) and group N (mean 9.38 +/- 6.44).

Conclusions: Edaravone was found to be associated with better neurological outcome at 3 months. Citicoline's role as a neuroprotective agent however remains controversial in acute ischaemic stroke.