Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke: A randomized controlled pilot study

Hiroaki Naritomi, Hiroshi Moriwaki, Norifumi Metoki, Hiroyuki Nishimura, Yasuto Higashi, Yasumasa Yamamoto, Hiroyuki Yuasa, Hiroshi Oe, Kortaro Tanaka, Kozue Saito, Yasuo Terayama, Tadafumi Oda, Norio Tanahashi, Hisao Kondo

研究成果: ジャーナルへの寄稿記事

20 引用 (Scopus)

抄録

Background and Objective: Stroke patients with severe leg paralysis are often bedridden in the acute and subacute phase, which increases the risk of disuse muscle atrophy in the chronic phase. The evidence to date indicates that oxidative stress plays an important role in the mechanism of disuse muscle atrophy. Therefore, the aim of this study was to determine if long-term radical scavenger treatment with edaravone following an acute stroke prevents the progression of disuse muscle atrophy and improves leg locomotor function in the chronic phase. Methods: This randomized controlled pilot study was conducted at 19 acute stroke and rehabilitation centers across Japan. Forty-seven ischemic stroke patients with at least leg motor weakness admitted within 24 hours of onset were randomly assigned to receive continuous intravenous infusions of edaravone 30mg twice daily for 3 days (short-term group) or 1014 days (long-term group). The primary endpoints of the study included the degree of leg disuse muscle atrophy, as measured by the percentage change from baseline in femoral muscle circumference 15 cm above the knee, and the improvement in leg locomotor function, as assessed by the maximum walking speed over 10 m, 3 months after the onset of stroke. Results: Three-month follow-up was completed by a total of 41 patients (21 in the short-term group and 20 in the long-term group). On admission, there was no significant difference in the severity of stroke or the grade of leg paresis between the two treatment groups. The grade of disuse muscle atrophy and incidence of gait impairment 3 weeks after stroke onset were also similar between the short- and long-term groups. However, disuse muscle atrophy of the paretic and non-paretic legs was significantly less severe in the long-term versus the short-term treatment group (3.6±5.9% and 1.5±6.0% vs 8.3±5.2% and 5.7±6.4%; p<0.01 and p<0.05) 3 months after stroke onset. Additionally, the maximum walking speed over a distance of 10m was significantly greater in the long-term group (98±67 vs 54±55 cm/sec; p< 0.05). Conclusion: Edaravone treatment for up to 14 days suppresses the progression of disuse muscle atrophy and improves leg locomotor function to a greater extent than shorter-term treatment in acute stroke patients. This suggests that the management of stroke may be improved with long-term edaravone therapy by providing myoprotective effects that ameliorate functional outcome in the chronic phase.

元の言語英語
ページ(範囲)155-163
ページ数9
ジャーナルDrugs in R and D
10
発行部数3
DOI
出版物ステータス出版済み - 12 1 2010

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Muscular Atrophy
Atrophic Muscular Disorders
Stroke
Leg
Therapeutics
phenylmethylpyrazolone
Rehabilitation Centers
Paraplegia
Paresis
Thigh
Gait
Intravenous Infusions
Knee
Japan
Oxidative Stress
Muscles

All Science Journal Classification (ASJC) codes

  • Pharmacology

これを引用

Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke : A randomized controlled pilot study. / Naritomi, Hiroaki; Moriwaki, Hiroshi; Metoki, Norifumi; Nishimura, Hiroyuki; Higashi, Yasuto; Yamamoto, Yasumasa; Yuasa, Hiroyuki; Oe, Hiroshi; Tanaka, Kortaro; Saito, Kozue; Terayama, Yasuo; Oda, Tadafumi; Tanahashi, Norio; Kondo, Hisao.

:: Drugs in R and D, 巻 10, 番号 3, 01.12.2010, p. 155-163.

研究成果: ジャーナルへの寄稿記事

Naritomi, H, Moriwaki, H, Metoki, N, Nishimura, H, Higashi, Y, Yamamoto, Y, Yuasa, H, Oe, H, Tanaka, K, Saito, K, Terayama, Y, Oda, T, Tanahashi, N & Kondo, H 2010, 'Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke: A randomized controlled pilot study', Drugs in R and D, 巻. 10, 番号 3, pp. 155-163. https://doi.org/10.2165/11586550-000000000-00000
Naritomi, Hiroaki ; Moriwaki, Hiroshi ; Metoki, Norifumi ; Nishimura, Hiroyuki ; Higashi, Yasuto ; Yamamoto, Yasumasa ; Yuasa, Hiroyuki ; Oe, Hiroshi ; Tanaka, Kortaro ; Saito, Kozue ; Terayama, Yasuo ; Oda, Tadafumi ; Tanahashi, Norio ; Kondo, Hisao. / Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke : A randomized controlled pilot study. :: Drugs in R and D. 2010 ; 巻 10, 番号 3. pp. 155-163.
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T1 - Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke

T2 - A randomized controlled pilot study

AU - Naritomi, Hiroaki

AU - Moriwaki, Hiroshi

AU - Metoki, Norifumi

AU - Nishimura, Hiroyuki

AU - Higashi, Yasuto

AU - Yamamoto, Yasumasa

AU - Yuasa, Hiroyuki

AU - Oe, Hiroshi

AU - Tanaka, Kortaro

AU - Saito, Kozue

AU - Terayama, Yasuo

AU - Oda, Tadafumi

AU - Tanahashi, Norio

AU - Kondo, Hisao

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Background and Objective: Stroke patients with severe leg paralysis are often bedridden in the acute and subacute phase, which increases the risk of disuse muscle atrophy in the chronic phase. The evidence to date indicates that oxidative stress plays an important role in the mechanism of disuse muscle atrophy. Therefore, the aim of this study was to determine if long-term radical scavenger treatment with edaravone following an acute stroke prevents the progression of disuse muscle atrophy and improves leg locomotor function in the chronic phase. Methods: This randomized controlled pilot study was conducted at 19 acute stroke and rehabilitation centers across Japan. Forty-seven ischemic stroke patients with at least leg motor weakness admitted within 24 hours of onset were randomly assigned to receive continuous intravenous infusions of edaravone 30mg twice daily for 3 days (short-term group) or 1014 days (long-term group). The primary endpoints of the study included the degree of leg disuse muscle atrophy, as measured by the percentage change from baseline in femoral muscle circumference 15 cm above the knee, and the improvement in leg locomotor function, as assessed by the maximum walking speed over 10 m, 3 months after the onset of stroke. Results: Three-month follow-up was completed by a total of 41 patients (21 in the short-term group and 20 in the long-term group). On admission, there was no significant difference in the severity of stroke or the grade of leg paresis between the two treatment groups. The grade of disuse muscle atrophy and incidence of gait impairment 3 weeks after stroke onset were also similar between the short- and long-term groups. However, disuse muscle atrophy of the paretic and non-paretic legs was significantly less severe in the long-term versus the short-term treatment group (3.6±5.9% and 1.5±6.0% vs 8.3±5.2% and 5.7±6.4%; p<0.01 and p<0.05) 3 months after stroke onset. Additionally, the maximum walking speed over a distance of 10m was significantly greater in the long-term group (98±67 vs 54±55 cm/sec; p< 0.05). Conclusion: Edaravone treatment for up to 14 days suppresses the progression of disuse muscle atrophy and improves leg locomotor function to a greater extent than shorter-term treatment in acute stroke patients. This suggests that the management of stroke may be improved with long-term edaravone therapy by providing myoprotective effects that ameliorate functional outcome in the chronic phase.

AB - Background and Objective: Stroke patients with severe leg paralysis are often bedridden in the acute and subacute phase, which increases the risk of disuse muscle atrophy in the chronic phase. The evidence to date indicates that oxidative stress plays an important role in the mechanism of disuse muscle atrophy. Therefore, the aim of this study was to determine if long-term radical scavenger treatment with edaravone following an acute stroke prevents the progression of disuse muscle atrophy and improves leg locomotor function in the chronic phase. Methods: This randomized controlled pilot study was conducted at 19 acute stroke and rehabilitation centers across Japan. Forty-seven ischemic stroke patients with at least leg motor weakness admitted within 24 hours of onset were randomly assigned to receive continuous intravenous infusions of edaravone 30mg twice daily for 3 days (short-term group) or 1014 days (long-term group). The primary endpoints of the study included the degree of leg disuse muscle atrophy, as measured by the percentage change from baseline in femoral muscle circumference 15 cm above the knee, and the improvement in leg locomotor function, as assessed by the maximum walking speed over 10 m, 3 months after the onset of stroke. Results: Three-month follow-up was completed by a total of 41 patients (21 in the short-term group and 20 in the long-term group). On admission, there was no significant difference in the severity of stroke or the grade of leg paresis between the two treatment groups. The grade of disuse muscle atrophy and incidence of gait impairment 3 weeks after stroke onset were also similar between the short- and long-term groups. However, disuse muscle atrophy of the paretic and non-paretic legs was significantly less severe in the long-term versus the short-term treatment group (3.6±5.9% and 1.5±6.0% vs 8.3±5.2% and 5.7±6.4%; p<0.01 and p<0.05) 3 months after stroke onset. Additionally, the maximum walking speed over a distance of 10m was significantly greater in the long-term group (98±67 vs 54±55 cm/sec; p< 0.05). Conclusion: Edaravone treatment for up to 14 days suppresses the progression of disuse muscle atrophy and improves leg locomotor function to a greater extent than shorter-term treatment in acute stroke patients. This suggests that the management of stroke may be improved with long-term edaravone therapy by providing myoprotective effects that ameliorate functional outcome in the chronic phase.

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