Tocilizumab may exert neuroprotective effects in patients with ischemic stroke undergoing endovascular treatment
Vascular recanalization techniques, including thrombolysis and thrombectomy, have become the mainstay of treatment for acute ischemic stroke. However, some patients still experience poor prognosis, with ineffective recanalization and reperfusion brain injury being the major contributors to unfavorable outcomes. Studies have indicated that tocilizumab, used in ST-segment elevation and non-ST-segment elevation myocardial infarction, exhibits anti-inflammatory and myocardial protective effects. Nevertheless, whether tocilizumab can provide neuroprotection in the early stages of acute large vessel recanalization remains uncertain. Given the above evidence, the aim of this study was to investigate whether combination therapy with tocilizumab in the early phase of recanalization of acute large vessel occlusion could further exert a beneficial effect and thus improve the poor prognosis of patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
108
Single dose intravenous application
Single dose intravenous application
Suzhou Municipal Hospital of Anhui Province
Suzhou, Anhui, China
Change from baseline in infarct-core volume
The infarct-core volume is determined by diffusion-weighted MRI, CT, or CTP images.
Time frame: 72 hours
Early neurological improvement
Decrease in National Institute of Health stroke scale (NIHSS) score of ≥8 or NIHSS score of 0-2 within 24 hours. NIHSS scores range from 0 to 42, with higher scores indicating greater neurologic deficit
Time frame: within 24 hours
NIHSS score
National Institutes of Health Stroke Scale (NIHSS) scores range from 0 to 42, with higher scores indicating greater neurologic deficit
Time frame: 24 hours
Proportion of successful reperfusion (mTICI 2b/3)
mTICI denotes modified Treatment in Cerebral Ischemia classification, with scores ranging from 0 (no flow) to 3 (normal flow)
Time frame: immediate postoperative
Proportion of recanalization on follow-up CTA or MRA
Time frame: 72 hours
Incidence of cerebral hemorrhage
Time frame: 72 hours
Incidence of symptomatic cerebral hemorrhage
Time frame: 72 hours
NIHSS score
National Institutes of Health Stroke Scale (NIHSS) scores range from 0 to 42, with higher scores indicating greater neurologic deficit
Time frame: 7 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Incidence of stroke-associated pneumonia
Time frame: 7 days
Incidence of decompressive craniectomy
Time frame: 7 days
Proportion of patients with functional independence (mRS 0-2)
Scores on the modified Rankin scale range from 0 to 6, with higher scores indicating greater disability
Time frame: 90 days
Shift analysis of mRS score
Scores on the modified Rankin scale range from 0 to 6, with higher scores indicating greater disability
Time frame: 90 days
Barthel Index
The Barthel index is an ordinal scale for measuring performance of activities of daily living. Scores ranges from 0 to 20, with 0 indicating severe disability and 19 or 20 indicating no disability that interferes with daily activities.
Time frame: 90 days
EuroQoL Group 5-Dimension Self-Report Questionnaire (EQ-5D)
EQ-5D is a standardized instrument for the measurement of health status. Scores range from -0.33 to 1.00, with higher scores indicating a better quality of life
Time frame: 90 days
Death
Time frame: 90 days
Adverse events and serious adverse events
Time frame: 90 days