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Effect of Lomerizine Hydrochloride on Preventing Strokes in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy.
Watanabe-Hosomi, Akiko; Mizuta, Ikuko; Koizumi, Takashi; Yokota, Isao; Mukai, Mao; Hamano, Ai; Kondo, Masaki; Fujii, Akihiro; Matsui, Masaru; Matsuo, Koushun; Ito, Keita; Teramukai, Satoshi; Yamada, Kei; Nakagawa, Masanori; Mizuno, Toshiki.
Afiliación
  • Watanabe-Hosomi A; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Mizuta I; Department of Neurology, Fukuchiyama City Hospital, Kyoto, Japan.
  • Koizumi T; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Yokota I; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Mukai M; Department of Neurology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Hamano A; Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.
  • Kondo M; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Fujii A; Department of Neurology, Kyoto Yamashiro General Medical Center, Kyoto, Japan.
  • Matsui M; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Matsuo K; Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Ito K; Department of Neurology, Saiseikai Shiga Hospital, Shiga, Japan.
  • Teramukai S; Department of Neurology, Otsu Red-Cross Hospital, Shiga, Japan.
  • Yamada K; Department of Neurology, Omihachiman Community Medical Center, Shiga, Japan.
  • Nakagawa M; Department of Neurology, Hekinan Municipal Hospital, Aichi, Japan.
  • Mizuno T; Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Clin Neuropharmacol ; 43(5): 146-150, 2020.
Article en En | MEDLINE | ID: mdl-32947425
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an orphan disease clinically characterized by migraine, recurrent strokes, and dementia. Currently, there are no disease-modifying therapies, and it is difficult to prevent cerebral ischemic events in CADASIL patients by conventional antithrombotic medication. We hypothesized that an antimigraine agent, lomerizine hydrochloride, may prevent strokes in CADASIL patients, based on its effect on increasing cerebral blood flow. SUBJECTS AND METHODS: This was an open-labeled clinical trial in which 30 adult CADASIL patients received lomerizine at 10 mg/d. Numbers of symptomatic strokes during the 2 years after the start of lomerizine administration were compared with those in the 2 years before its initiation. The effect of lomerizine on preventing strokes was evaluated based on the incidence rate ratio (IR) calculated with the Mantel-Haenszel method. RESULTS: When including all 30 patients (analysis 1), the IR was less than 1 (0.46; 95% confidence interval [CI], 0.19-1.12) but did not reach significance. To evaluate the effect of lomerizine on secondary prevention, subgroups of 15 patients with stroke episodes occurring any time before lomerizine administration (analysis 2) and 10 patients with stroke episodes during the 2 years before lomerizine administration (analysis 3) were analyzed. The IR values were 0.33 (95% CI, 0.12-0.94) in analysis 2 and 0.17 (95% CI, 0.04-0.67) in analysis 3. CONCLUSIONS: Our results suggest the effect of lomerizine on preventing secondary stroke in CADASIL patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Piperazinas / CADASIL / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Incidence_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neuropharmacol Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Piperazinas / CADASIL / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Incidence_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Neuropharmacol Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos