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Titolo:
Neuroprotective agents in traumatic brain injury
Autore:
Maas, AIR;
Indirizzi:
Erasmus Univ, Med Ctr, Dept Neurosurg, NL-3015 GD Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3015 GD GD Rotterdam, Netherlands
Titolo Testata:
EXPERT OPINION ON INVESTIGATIONAL DRUGS
fascicolo: 4, volume: 10, anno: 2001,
pagine: 753 - 767
SICI:
1354-3784(200104)10:4<753:NAITBI>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEVERE HEAD-INJURY; NERVOUS-SYSTEM TRAUMA; RANDOMIZED CONTROLLED TRIALS; B-2 RECEPTOR ANTAGONIST; FLUID-PERCUSSION INJURY; CORTICAL IMPACT INJURY; CEREBRAL-ISCHEMIA; RAT-BRAIN; SUBARACHNOID HEMORRHAGE; LIPID-PEROXIDATION;
Keywords:
clinical trials; head injury; neuroprotection; traumatic brain injury;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
98
Recensione:
Indirizzi per estratti:
Indirizzo: Maas, AIR Erasmus Univ, Med Ctr, Dept Neurosurg, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands Erasmus Univ Dr Molewaterpl 40 Rotterdam Netherlands NL-3015 GD
Citazione:
A.I.R. Maas, "Neuroprotective agents in traumatic brain injury", EXPERT OP I, 10(4), 2001, pp. 753-767

Abstract

The role of neuroprotection in traumatic brain injury (TBI) is reviewed. Basic research and experimental investigations have identified many different compounds with potential neuroprotective effect. However, none of the Phase III trials performed in TBI have been successful in convincingly demonstrating efficacy in the overall population. A common misconception is that consequently these agents are ineffective. The negative results as reported in the overall population may in part be caused by specific aspects of the head injury population as well as by aspects of clinical trial design and analysis. The heterogeneity of the TBI population causes specific problems, such as a risk of imbalances between placebo and treated groups but also causes problems m;hen a possible treatment effect is evaluated in relation tothe prognostic effect present. Trials of neuroprotective agents should be targeted first of all to a population in which the mechanism at which the agent is directed is likely to be present and secondly to a population in which the chances of demonstrating efficacy are realistic, e.g., to patients with an intermediate prognosis. The possibilities for concomitant or sequential administration of different neuroprotective agents at different times deserve consideration. The potential for neuroprotection in TBI remains high and we should not be discouraged by recent failures obtained up until now. Rather, prior to initiating new trials, careful consideration of experimental evidence is required in order to optimise chances for mechanistic targeting and lessons learned from previous experience need to be taken to heart in the design of future studies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 19:31:39