Effects of Policosanol on Patients with Ischemic Stroke: A Pilot Open Study

Abstract

Stroke is a major health problem worldwide. Its pharmacological management includes thrombolytic therapy for the acute phase and antiplatelet drugs for stroke recovery and prevention. Statins can help in the acute phase and in preventing stroke in secondary prevention patients. Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects, with protective effects in stroke models. This observational study investigated the effects of policosanol (20 mg/day) administered during the acute phase and for 5 years later on the neurological recovery of patients with ischemic stroke treated with antiplatelets and vitamins. After hospital discharge, patients were followed up every 3 (first year) and 6 (thereafter) months. Neurological improvement was assessed with the modified Canadian Neurological Scale. Adverse events were recorded. Fifty patients were included; all completed the study. Neurological score improved throughout the study. No patient died, and most [40 (80.0%)] did not experience new vascular events; only one (2.0%) suffered a new stroke, and two (4.0%) suffered more than one transient ischemic attack. The time to the first recurrent event was 46.2 months. Policosanol persistently lowered serum total cholesterol, with such reduction correlating with the neurological improvement (R = 0.995253301). Triglycerides were unchanged. Treatment was well tolerated. Policosanol administered to patients suffering ischemic stroke treated with aspirin and vitamins showed good results on neurological outcomes and recurrent events. This study, however, has limitations, since it was open and uncontrolled, and patients also consumed aspirin and vitamins. New randomized, controlled studies are needed to assess the usefulness of policosanol in stroke management.

Effects of policosanol on the recovery of ischemic stroke: a randomized controlled study

“…These results are consistent with previous data of the effects of policosanol in patients with ischemic stroke obtained in two open, uncontrolled, long-term studies, whose designs had limitations for strong conclusions [17,18]. Benefits of poli + AS treatment on platelet aggregation were also seen.…”

“…Consistent with previous studies in stroke patients [17,18], poli + AS treatment was safe and well tolerated. No patient discontinued the study due to AE, the frequency of AE was low, and all AE were mild.…”

“…Their open and uncontrolled designs, however, had methodological limitations for strong conclusions [17,18].…”

Effects Of Policosanol Plus Aspirin Therapy On The Neurological Recovery And Plasma Oxidative Markers Of Patients With Ischemic Stroke

“…Also, policosanol has shown protective effects in experimental brain ischemia models [20,21], and long-term administered prevented the progression of carotid-vertebral atherosclerosis in humans [22]. Two open and long-term clinical studies found that the addition of policosanol to aspirin (AS) therapy was associated to very good neurological recovery [23,24], and a further double-blind, placebo-controlled study demonstrated that policosanol + AS treatment improved the neurological recovery and decreased platelet aggregation in patients with recent ischemic stroke [25].In light of this background, this study investigated the effects of the therapy with policosanol 20 mg/day + AS 125 mg/day (poli + AS) on the neurological outcome and plasma oxidative variables in patients who had suffered a recent ischemic stroke as compared to placebo + AS 125 mg/day (pla + AS).…”

Synthesis of Water‐Soluble Copolymers Carrying Long‐Chain (C12 to C30) Aliphatic Moieties

“…[1] The growing interest in extracting and using these alcohols is motivated by their medical [2][3][4] and agricultural applications. [5] Policosanols have demonstrated to be effective in the treatment of various chronic diseases including diabetes and hypercholesterolemia, [6,7] in the prevention and the treatment of cardiovascular diseases [8] and in inflammatory diseases. [9] Policosanols have also been widely investigated in the agricultural field, in particular after the discovery of 1-triacontanol (C 30 OH) in the 70s [10] as a potent plant growth promoting substance of many agricultural and horticultural crops.…”