Piracetam for Acute Stroke
Source: DeDeyn PP, et al. Treatment of acute stroke with piracetam. Stroke 1997;28:2347-2352.
Piracetam, a drug under evaluation since the early 1980s, has undergone repeated but unsuccessful efforts to show an outcome advantage in acute stroke. This new double-blinded trial of the agent was carried out on a randomized 927 patients experiencing an acute stroke 12 or less hours prior to treatment. A subgroup of 452 patients receiving piracetam within less than seven hours after stroke onset was evaluated both as part of the total numbers study and as if independent of the whole. Analysis of the total group was carried out by Orgogozo scales at four weeks and Barthel indices at 12 weeks. Individual mortality was similar between treats and non- treats as was overall outcome. A secondary selective analysis of 224 patients receiving piracetam vs. 228 receiving placebos within seven hours after stroke onset showed, at 12 weeks, a significantly better Barthel index score (58.6 ± 42.8) for treats compared to controls (49.4 ± 43.2). Orgogozo scores at four weeks, however, were not significantly different between treats and controls, and mortalities were the same at 19.6-7%. The data suggest that piracetam, if it works at all, does best if given early and to patients with not very severe strokes. fp
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