a Department of Neurosciences and Preventive Medicine , Danube University Krems , Krems , Austria.
Expert Rev Neurother. 2018 Aug;18(8):681-687. doi: 10.1080/14737175.2018.1500459. Epub 2018 Jul 18.
Cerebrolysin is a neuropeptide preparation with neurotrophic effects and promotes recovery after brain injury. Its preclinical profile promises wide applications due to its multi-target effects. Currently, Cerebrolysin is used for treatment of cerebral ischemia and neurodegeneration. Areas covered: In stroke, earlier clinical trials with Cerebrolysin were performed mostly in mildly affected stroke populations, which usually have a favorable prognosis. Due to this selection, a floor or ceiling effect of recovery measures in the mild cases may have prevented to show a clear benefit between treatment groups. In contrast, subgroup analyses of more severely affected patients reveal a strikingly positive effect for enhanced recovery. Based on the findings from several studies, it became evident that the effect size of Cerebrolysin was increasing with stroke severity. Other controlled studies showed that Cerebrolysin can be safely used in combination with thrombolysis. More recently, Cerebrolysin has been tested not only for neuroprotection but also for its neurorecovery potential and also showed efficacy in patients with moderate to severe strokes. Expert commentary: Cerebrolysin shows a benefit mostly in moderate to severe ischemic stroke patients and an overall significant effect for functional recovery when combined with neurorehabilitation versus neurorehabilitation alone. This gives lead to the planning of a more rigorous study design in the future.
脑活素是一种具有神经营养作用的神经肽制剂，能促进脑损伤后的恢复。其多靶点作用使其在临床前表现出广泛的应用前景。目前，脑活素用于治疗脑缺血和神经退行性疾病。
在中风中，早期的脑活素临床试验主要在轻度中风人群中进行，这些患者通常预后良好。由于这种选择，轻度病例的恢复措施可能已经达到了上限或下限，从而阻止了治疗组之间的明显获益。相比之下，对更严重的患者亚组的分析显示，增强恢复有明显的积极作用。基于几项研究的结果，脑活素的效果大小随着中风的严重程度而增加。其他对照研究表明，脑活素可以与溶栓联合安全使用。最近，脑活素不仅用于神经保护，还用于其神经恢复潜力的研究，在中重度中风患者中也显示出疗效。
脑活素对中重度缺血性中风患者有效，与神经康复治疗相比，联合神经康复治疗对功能恢复有显著的整体效果。这为未来更严格的研究设计提供了依据。
