Abstract:More rapid and complete regression of neurological deficit, better recovery of self-care function, cognitive function and social activity, an increase in erythrocyte membrane elasticity were found in the main group compared to the control one. These results indicate the efficacy of cavinton R and cavinton R comforte in the regimen used in complex treatment in acute and early recovery periods after ischemic stroke.
“…1 ). Ultimately, 17 articles were selected for full-text review, out of which four placebo-controlled RCTs were found to be eligible (one double-blind, one single-blind, and two open-label RCTs), enrolling a total of 601 and 236 patients in the vinpocetine and placebo groups, respectively [ 9 , 11 , 15 , 16 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…All these RCTs included patients with acute arterial ischemic stroke only. The cutoff time interval for enrolment in the study was between 24 h to 14 days in these RCTs, but all of them excluded patients with very severe arterial ischemic stroke, with high NIHSS scores (> 17 and > 25 in the study by Zhang et al [ 11 ] and Belova et al [ 15 ], respectively). All these RCTs excluded patients with significant coexistent other psychiatric disorders, dementia, severe, uncontrolled cardiac, renal, hepatic, or endocrinal impairment including myocardial infarction, and those with evidence of hemorrhage on neuroimaging.…”
Section: Resultsmentioning
confidence: 99%
“…Although Zhang et al [ 11 ] used a dosage of 30 mg intravenously once daily for 7 days, Werner et al [ 16 ] used a dosage of 40 mg intravenously once daily for 3 weeks, Feigin et al [ 9 ] used a dosage of 10 mg intravenously once daily for 5–7 consecutive days followed by 10 mg orally three times a day for 30 days and Belova et al [ 15 ] used a dosage of 10 mg intravenously for 10 days followed by 30 mg/day for 90 days. The overall median dosage was 30 mg/day and the median follow-up duration was 3 months (range 1–6 months).…”
Background
Vinpocetine as a neuroprotective agent is effective in acute ischemic stroke in some randomized controlled trials (RCTs). Since the last systematic review has been published in 2008, which didn’t find conclusive evidence favoring its use, two more RCTs have also been completed.
Methods
Relevant electronic databases were searched with a suitable combination of Medical Subject Headings terms to detect publications describing RCTs exploring the safety and efficacy of vinpocetine in patients with acute ischemic stroke. The risk of bias was determined by using the Cochrane Collaboration’s tool for assessing the risk of bias in RCTs after full-text review and relevant data extraction. Higgins and Thompson’s
I
2
method was used to assess heterogeneity in studies. The presence of publication bias was assessed by Egger’s test. We used a random effect model when
I
2
was more than 50% and a fixed-effect model for other parameters.
Results
Four placebo-controlled RCTs enrolling a total of 601 and 236 patients in vinpocetine and placebo groups, respectively, were included. The number of patients with death or significant disability was lower in the vinpocetine group than that in the placebo group at both 1 and 3 months (relative risk 0.80, 95% confidence interval [CI] 0.65–0.99 and relative risk 0.67, CI 0.48–0.92,
p
= 0.04 and 0.02, respectively). The degree of disability in participants at 1 month and 3 months was also lower in vinpocetine group than that in the placebo group (standardized mean difference (SMD) 0.49, 95% CI 0.03–0.95 and SMD 1.22, CI 0.23–2.24,
p
= 0.001 and 0.04, respectively). Change in mini-mental state examination score compared with baseline at trial enrolment was also better in the vinpocetine group than in the placebo group (pooled weighted mean difference 0.92, 95% CI 0.02–1.82,
p
= 0.04).
Conclusions
Vinpocetine has some promising efficacy in patients with ischemic stroke when used in the acute stage in reducing the disability, but presently there is not enough evidence to suggest that it also reduces case fatality. More double-blind, placebo-controlled RCTs of adequate sample size are needed before making recommendations for the routine administration of vinpocetine for all patients with acute ischemic stroke.
Supplementary Information
The online version contains supplementary material available at 10.1007/s12028-022-01499-y.
“…1 ). Ultimately, 17 articles were selected for full-text review, out of which four placebo-controlled RCTs were found to be eligible (one double-blind, one single-blind, and two open-label RCTs), enrolling a total of 601 and 236 patients in the vinpocetine and placebo groups, respectively [ 9 , 11 , 15 , 16 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…All these RCTs included patients with acute arterial ischemic stroke only. The cutoff time interval for enrolment in the study was between 24 h to 14 days in these RCTs, but all of them excluded patients with very severe arterial ischemic stroke, with high NIHSS scores (> 17 and > 25 in the study by Zhang et al [ 11 ] and Belova et al [ 15 ], respectively). All these RCTs excluded patients with significant coexistent other psychiatric disorders, dementia, severe, uncontrolled cardiac, renal, hepatic, or endocrinal impairment including myocardial infarction, and those with evidence of hemorrhage on neuroimaging.…”
Section: Resultsmentioning
confidence: 99%
“…Although Zhang et al [ 11 ] used a dosage of 30 mg intravenously once daily for 7 days, Werner et al [ 16 ] used a dosage of 40 mg intravenously once daily for 3 weeks, Feigin et al [ 9 ] used a dosage of 10 mg intravenously once daily for 5–7 consecutive days followed by 10 mg orally three times a day for 30 days and Belova et al [ 15 ] used a dosage of 10 mg intravenously for 10 days followed by 30 mg/day for 90 days. The overall median dosage was 30 mg/day and the median follow-up duration was 3 months (range 1–6 months).…”
Background
Vinpocetine as a neuroprotective agent is effective in acute ischemic stroke in some randomized controlled trials (RCTs). Since the last systematic review has been published in 2008, which didn’t find conclusive evidence favoring its use, two more RCTs have also been completed.
Methods
Relevant electronic databases were searched with a suitable combination of Medical Subject Headings terms to detect publications describing RCTs exploring the safety and efficacy of vinpocetine in patients with acute ischemic stroke. The risk of bias was determined by using the Cochrane Collaboration’s tool for assessing the risk of bias in RCTs after full-text review and relevant data extraction. Higgins and Thompson’s
I
2
method was used to assess heterogeneity in studies. The presence of publication bias was assessed by Egger’s test. We used a random effect model when
I
2
was more than 50% and a fixed-effect model for other parameters.
Results
Four placebo-controlled RCTs enrolling a total of 601 and 236 patients in vinpocetine and placebo groups, respectively, were included. The number of patients with death or significant disability was lower in the vinpocetine group than that in the placebo group at both 1 and 3 months (relative risk 0.80, 95% confidence interval [CI] 0.65–0.99 and relative risk 0.67, CI 0.48–0.92,
p
= 0.04 and 0.02, respectively). The degree of disability in participants at 1 month and 3 months was also lower in vinpocetine group than that in the placebo group (standardized mean difference (SMD) 0.49, 95% CI 0.03–0.95 and SMD 1.22, CI 0.23–2.24,
p
= 0.001 and 0.04, respectively). Change in mini-mental state examination score compared with baseline at trial enrolment was also better in the vinpocetine group than in the placebo group (pooled weighted mean difference 0.92, 95% CI 0.02–1.82,
p
= 0.04).
Conclusions
Vinpocetine has some promising efficacy in patients with ischemic stroke when used in the acute stage in reducing the disability, but presently there is not enough evidence to suggest that it also reduces case fatality. More double-blind, placebo-controlled RCTs of adequate sample size are needed before making recommendations for the routine administration of vinpocetine for all patients with acute ischemic stroke.
Supplementary Information
The online version contains supplementary material available at 10.1007/s12028-022-01499-y.
“…Vinpocetine's most well-documented clinical use (indirect) has been in acute ischemic stroke, where it has been characterized as a neuroprotective agent. Over ten trials, including more than five randomized controlled trials, have been conducted in the past, and researchers have provided systematic reviews on vinpocetine's effectiveness [31][32][33][34][35]. However, the final verdict on its effectiveness still remains unclear.…”
Section: Vinpocetine-what Do We Know So Far?mentioning
This paper examines the use of vinpocetine in the context of clinical pharmacology. The main and active metabolite of vinpocetine is apovincaminic acid (AVA). Due to the scarce information in the literature on AVA pharmacokinetics, we propose a population pharmacokinetic (PopPK) model for AVA based on a study in healthy volunteers with three different formulations of vinpocetine. The suggested PopPK model (and simulations) could be helpful in ensuring the more effective and safer use of the vinpocetine in the future given the increasing range of suggested indications for its use.
Цель исследования. Изучение влияния приема кавинтона комфорте (КК) на выраженность когнитивных нарушений и моторной неловкости у больных с хронической ишемией головного мозга (ХИГМ). Материал методы. Наблюдали 30 пациентов (8 мужчин, 22 женщины) в возрасте 50-65 лет (в среднем 61,6±4,9 года) с ХИГМ с когнитивными нарушениями. Использовали тесты МINI-Cog, Мюнстерберга, TMT), ADL). КК назначали по 10 мг/сут 3 раза в течение 3 мес. Результаты и обсуждение. На фоне терапии отмечено улучшение конструктивного праксиса и кратковременной памяти, увеличение скорости зрительного поиска и зрительно-моторной функции, повышение уровня избирательности внимания, улучшение репродукции зрительных образов и восприятия, увеличение скорости выполнения моторного задания (рисование штрихов). Заключение. Полученные данные могут свидетельствовать об улучшении показателей функции мелкой моторики кисти на фоне улучшения когнитивных функций.
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