Safety and efficacy of NA-1 in patients with iatrogenic stroke after endovascular aneurysm repair (ENACT): a phase 2, randomised, double-blind, placebo-controlled trial

Extracranial-intracranial bypass for ischemic cerebrovascular disease: what have we learned from the Carotid Occlusion Surgery Study?

“…The authors found that patients receiving the drug (n = 93) sustained fewer ischemic infarcts than did patients receiving a placebo (n = 93), as measured by diffusion-weighted MRI. 22 A second approach could be employing a lessinvasive and lower-risk revascularization procedure-for example, endovascular recanalization. This approach has been successfully applied to patients with subacute to chronic stage ICA occlusion in several small case series with reported low rates of perioperative morbidity.…”

Importance of Preclinical Research in the Development of Neuroprotective Strategies for Ischemic Stroke

“…33 A recent phase II clinical trial for patients undergoing aneurysm coiling (ie, at considerable risk of iatrogenic embolic strokes) demonstrated the safety of NA-1 and provided limited evidence for its efficacy. 34 Currently, there are no phase III trial data that would provide definitive conclusions regarding its clinical efficacy. Despite this, NA-1 is an excellent example of the rigor that experimental ischemic neuroprotection has adopted since the high-profile failures of the recent past, in its use of multiple in vitro and in vivo models, adherence to STAIR criteria, and use of trials featuring tightly controlled patient populations.…”

The neuroprotective potential of arginine-rich peptides for the acute treatment of traumatic brain injury

“…Although TBI is more complex and heterogeneous than stroke, many neuroprotective therapeutics trialed for TBI were initially investigating for stroke, so it stands to reason that the neuroprotective potential of arginine-rich peptides may also extend to TBI. Moreover, substantial safety and efficacy in the administration of TAT-NR2B9c in humans and non-human primates has been established [24]. To this end, studies in our laboratory have shown that a poly-arginine-18 peptide is more neuroprotective than TAT-NR2B9c in both in vitro [11] and in vivo (unpublished observation) stroke models.…”