Reperfusion Combined with Neuroprotective Agents Treatment in Acute Ischemic Stroke: a Literature Review of Current Progress

Abstract

Acute ischemic stroke remains to be a heavy burden causing serious mortality and disability. Clinical studies of neuroprotective agents produced disappointing results in the treatment, and recanalization may be a precondition for it to be successful. By searching for relevant randomized controlled trials concerning combination therapy in the online databases and analyzing them, this literature review investigated the therapeutic effect of reperfusion combined with neuroprotective agents treatment in acute ischemic stroke. We found that reported trials specifically designed to investigate the efficacy of combination treatment are scarce. Overall, use of uric acid and nerinetide in the combination therapy exhibited positive results. These results indicate a high potential for clinical use with further confirmation. Future studies are still needed. They should focus on (1) designing clinical trials that investigate combination therapy specifically or include prespecified subgroup analyses for different types of recanalization, (2) reaffirming previous positive clinical trials with more patients of different characteristics or geographical locations, (3) employing multitarget neuroprotectant combinative therapy (cocktail therapy) to target multiple targets of ischemia-reperfusion injury instead of the currently prevalent single neuroprotectant with recanalization therapy.