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

Abstract

Background. Antiplatelet therapy lowers the risk of recurrent stroke. Policosanol, a mixture of 8 high molecular weight sugar cane wax alcohols, has shown to reduce platelet aggregation. Objectives. To investigate whether the therapy with policosanol plus aspirin (AS) could improve the neurological outcome as compared to placebo + AS in patients with a recent ischemic stroke. Methods. Ninety-two (92) patients with a modified Rankin Scale score (mRSs) ≥2 -≤4 after suffering an ischemic stroke within 30 days before enrollment were randomized to placebo or policosanol (20 mg/day) + AS (125 mg/day) (pla + AS or poli + AS) for 24 weeks. The primary efficacy variable was to obtain a better stroke outcome (mRSs ≤1) as compared to pla +AS. Reduction of platelet aggregation was a secondary variable. Results. After 12 and 24 weeks on therapy, the rates of patients treated with poli + AS (10/46, 21.7% and 32/46, 69.6%, respectively) who achieved mRSs ≤1 were significantly (p0.01 and p0.0001, respectively) greater than those treated with pla + AS (0/46, 0.0% and 7/46, 15.2%, respectively). Poli + AS treatment given for 6 weeks reduced significantly (p0.00001 vs baseline, p0.01 vs pla + AS) the mean mRSs value (24.1%), and this effect improved thereafter, so that it was reduced by 31.0% and 55.2% after 12 and 24 weeks on therapy, respectively. Poli + AS treatment also reduced significantly arachidonic acid-and adenosine diphosphateinduced platelet aggregation by 41.0% and 24.8%, respectively. Treatments were well tolerated. There were not withdrawals due to adverse experiences. Conclusions. In patients with recent ischemic stroke, poli + AS treatment improved the neurological recovery and decreased platelet aggregation as compared to pla + AS.

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

“…This double-blind, randomized and controlled study confirms that poli + AS treatment significantly improved stroke functional outcomes in patients who had suffered a recent (≤30 days) moderate to severe ischemic stroke, consistent with the results of a previous double-blind, randomized, controlled study conducted in post-ischemic stroke sufferers [25]. In addition, for the first time, beneficial effects of poli + AS treatment on plasma oxidative variables of these patients were also found.…”

“…No patient withdrew from the study, the frequency of AE was low and AE were mild. Systolic blood pressure decreased significantly with poli + AS versus pla + AS, consistent with previous results [23][24][25]. Nevertheless, since no patient had hypotension values and there was a high frequency of study patients with hypertension, this effect could be potentially beneficial, rather than adverse, for stroke recovery.…”

“…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).…”

Cuban policosanol: a natural compound for ischemic stroke treatment

“…The results of this study were encouraging as the CNS neurological score improved significantly and progressively over the 5 years study period of all the patients involved in the study, only one suffered a new stroke (1.8%), four (7.3%) experienced a new TIA, and fifty patients (90.9%) did not experience a new vascular event. No patient died during the trial and no other serious adverse effects occurred [48].…”

“…Given this result, a 60 months follow-up study was designed for 55 patients who suffered an ischemic stroke with a prior history of TIA, after hospital discharge. In this study, the neurological evolution of the patients was evaluated with the aim of demonstrating the usefulness of treatment with policosanol (20 mg/ day) plus aspirin (125 mg/day) [48].…”