TREATMENTS that prevent recurrence of types of stroke and dementia caused by damage to small blood vessels have moved a step closer following a small study.
It is the first time the drugs cilostazol and isosorbide mononitrate – already used to treat other conditions, such as heart disease and angina – have been tested in the UK for the treatment of the conditions.
A study led by the Universities of Edinburgh and Nottingham found that patients tolerated the drugs, with no serious side effects, even when the medication was given in full dose or in combination with others.
Damage to small blood vessels in the brain is responsible for around a quarter of strokes, known as a lacunar stroke. It is also a common cause of memory problems and dementia.
Around 400,000 people in the UK are affected but there are no specific treatments. Currently the only way to reduce risk of the disease is by controlling blood pressure and cholesterol, stopping smoking and managing symptoms of diabetes.
Dr James Pickett, head of research at Alzheimer’s Society, said: “There hasn’t been a new drug for dementia for 15 years, so finding evidence that these cheap existing drugs could prevent dementia after a stroke would be a huge breakthrough.
“It’s promising to see that these two drugs are safe to use and we’ll be excited to see the results of the next stage of testing in a couple of years, which will show whether these drugs can be an effective treatment.”
The team recruited 57 patients who had suffered a lacunar stroke. Patients took the two medicines, either individually or in combination, for up to nine weeks, in addition to usual treatments. They completed health questionnaires and had regular blood pressure checks, blood tests and brain scans. The findings suggest the drugs are safe for use in stroke patients, at least in the short term.
There were also signs that the treatments helped improve blood vessel function in the arms and brain, and may improve thinking skills, but the researchers stress that further studies are needed to test this. A larger study, called LACI-2, is already under way.
The study, published in EClinicalMedicine, was funded primarily by the Alzheimer’s Society, with support from the UK Stroke Association, British Heart Foundation, the EU, National Institutes of Health Research, and NHS Research Scotland.
Lead researcher Professor Joanna Wardlaw, of the University of Edinburgh’s Centre for Clinical Brain Sciences, said: “We are delighted that the results of this trial show promise for treating a common cause of stroke and the commonest cause of vascular dementia, since currently there are no effective treatments.”
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