Citicoline Disappoints as a Neuroprotectant After Ischemic Stroke

A large randomized clinical trial fails to demonstrate the benefit seen in prior, smaller studies.

Many efforts have been made to develop neuroprotective agents that can reduce brain injury from ischemia. Citicoline, an exogenous form of a choline that is involved in several steps of the ischemic cascade, is approved in several countries for use after ischemic stroke, and a meta-analysis suggested a clinical benefit from citicoline for this condition. However, uncertainty lingers about its effectiveness, and it remains unavailable in the U.S. Now, investigators report the results of the largest randomized clinical trial of citicoline for acute ischemic stroke.

In this manufacturer-funded, double-blinded, placebo-controlled trial, researchers enrolled 2298 patients within 24 hours after onset of symptoms of acute ischemic stroke affecting …

Reviewing Author

Hooman Kamel, MD

Disclosures

Speaker’s bureauGenentech

Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund

Editorial boardsPLOS One; Scientific Reports

Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)