University of California, Irvine Medical Center, 101 The City Drive South, Building 53, Room 203, Orange, CA 92868-4280, USA.
Stroke. 2010 May;41(5):927-31. doi: 10.1161/STROKEAHA.109.574343. Epub 2010 Mar 4.
Animal data suggest the use of beta-human chorionic gonadotropin followed by erythropoietin to promote brain repair after stroke. The current study directly translated these results by evaluating safety of this sequential growth factor therapy through a 3-center, single-dose, open-label, noncontrolled, Phase IIa trial.
Patients with ischemic stroke 24 to 48 hours old and National Institutes of Health Stroke Scale score of 6 to 24 started a 9-day course of beta-human chorionic gonadotropin (once daily on Days 1, 3, and 5 of study participation) followed by erythropoietin (once daily on Days 7, 8, and 9 of study participation). This study also evaluated performance of serially measured domain-specific end points.
A total of 15 patients were enrolled. Two deaths occurred, neither related to study medications. No safety concerns were noted among clinical or laboratory measures, including screening for deep vein thrombosis and serial measures of serum hemoglobin. In several instances, domain-specific end points provided greater insight into impairments as compared with global outcome measures.
Results support the safety of this sequential, 2-growth factor therapy initiated 24 to 48 hours after stroke onset.
动物研究数据表明,在卒中后使用β-人绒毛膜促性腺激素(β-hCG)和促红细胞生成素(EPO)联合治疗可促进大脑修复。本研究通过在 3 个中心开展的、为期 9 天的、单剂量、开放标签、非对照、2a 期临床试验,直接验证了该序贯生长因子治疗的安全性。
24 至 48 小时内发生缺血性卒中且 NIHSS 评分在 6 至 24 分的患者开始接受为期 9 天的治疗,即每日接受一次β-hCG(于研究入组第 1、3、5 天),随后每日接受一次 EPO(于研究入组第 7、8、9 天)。本研究还评估了序贯测量的特定领域终点的表现。
共纳入 15 例患者,其中 2 例死亡,均与研究药物无关。在临床或实验室检查中(包括深静脉血栓形成筛查和血清血红蛋白的连续测量)未发现任何安全性问题。在某些情况下,特定领域的终点比总体结局指标更能深入了解损伤情况。
这些结果支持在卒中发病后 24 至 48 小时开始进行这种序贯的 2 种生长因子治疗的安全性。