Front Panel Painting “LIFE” By William T Chua MD

CDP–choline has multimodal effects on the ischemic and reperfusion cascade. It helps increase
phosphatidylcholine synthesis for membrane stabilization and repair. It inhibits the activation
of phospholipase A2 and reduces oxygen free radicals and inflammatory cytokines within the
injured brain during ischemia.
A randomized double-blind placebo controlled trial on safety and efficacy of Citicoline 1 gm
twice a day in acute ischemic stroke within 24 hours for 6 weeks known as International
Citicoline Trial on Acute Stroke or ICTUS is currently underway to confirm results of the
pooled data analysis and meta–analysis.
The use of neuroprotectants in acute stroke remains a matter of preference by the
attending physician. The choice of Citicoline is a reasonable option.
Two other pharmacologic agents with putative neuroprotective properties are currently
undergoing or recently completed phase III clinical trials.
An international, multicenter double blinded, placebo controlled randomized controlled trial
on Neuroaid known as Chinese Medicine Efficacy in Stroke Recovery or CHIMES) among
patients with acute ischemic stroke within 72 hours is currently ongoing in several countries in
Asia including Singapore, Philippines, Thailand, Korea, Sri Lanka.
A double-blind placebo controlled randomized clinical trial to evaluate the safety and efficacy of
Cerebrolysin in patients with Acute Ischemic Stroke in Asia in ASIA (CASTA) was recently
completed with results due this year.
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Acute Stroke
Treatment