Design Issues in Selected Recent or Ongoing Stroke Trials
The basic science of cerebral ischemia is complex and involves multiple systems. As reviewed elsewhere, hypoperfusion, excitotoxicity, inflammation, and apoptosis are the main disease mechanisms that are tackled by pharmacological interventions. A large number of agents and strategies has been developed to change the pathophysiological cascade. While it has been a rather easy task to find agents that would work in the experimental setting, translation into the clinic has been a major problem. After more than two decades of dedicated clinical trials, only a single agent, rt-PA, has been approved by national agencies for routine use. This review will discuss pitfalls of prior clinical trials and the promise of upcoming strategies in clinical testing.
KeywordsPlacebo Toxicity Ischemia Heparin Neurol
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