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Clinical Trial
. 2020 Jan 15:408:116563.
doi: 10.1016/j.jns.2019.116563. Epub 2019 Nov 6.

MAMBO: Measuring ambulation, motor, and behavioral outcomes with post-stroke fluoxetine in Tanzania: Protocol of a phase II clinical trial

Andre C Vogel  1 , Kigocha Okeng'o  2 , Faraja Chiwanga  3 , Seif Sharif Ismail  2 , Deus Buma  4 , Lindsay Pothier  5 , Farrah J Mateen  6
Affiliations
Clinical Trial

MAMBO: Measuring ambulation, motor, and behavioral outcomes with post-stroke fluoxetine in Tanzania: Protocol of a phase II clinical trial

Andre C Vogel et al. J Neurol Sci. .

Abstract

Background: SSA 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 SSA.

Aim: To determine if fluoxetine 20 mg 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 differ substantially in Tanzania. If fluoxetine reveals favorable endpoints, scale up of its use post-stroke is possible.

Keywords: Africa; Fluoxetine; Ischemic stroke; Motor recovery; Neuroplasticity; Phase II clinical trial; Stroke.

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Conflict of interest statement

Declaration of interest: The authors have nothing to disclose.

Figures

Figure 1:
Figure 1:
Flowchart of recruitment, enrollment, and study procedures for the MAMBO study
See this image and copyright information in PMC

References

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