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Estudio URICOICTUS
¡Publicados los resultados del estudio URICO-ICTUS en Lancet Neurology! A pesar de las "pruedentes" conclusiones del abstract pensamos que los resultados son muy esperanzadores y merecen ser estudiados en un nuevo estudio multicéntrico adecuadamente potenciado para evaluar el verdadero efecto del ácido úrico en el tratamiento del ictus agudo. Este es el resumen del artículo:

Introduction

Uric acid is an antioxidant with neuroprotective effects in experimental models of stroke. We assessed whether uric acid therapy would improve functional outcomes at 90 days in patients with acute ischaemic stroke.

Methods

URICO-ICTUS was a randomised, double-blind, placebo-controlled, phase 2b/3 trial that recruited patients with acute ischaemic stroke admitted to ten Spanish stroke centres. Patients were included if they were aged 18 years or older, had received alteplase within 4·5 h of symptom onset, and had an eligible National Institutes of Health Stroke Scale (NIHSS) score (>6 and ≤25) and premorbid (assessed by anamnesis) modified Rankin Scale (mRS) score (≤2). Patients were randomly allocated (1:1) to receive uric acid 1000 mg or placebo (both infused intravenously in 90 min during the infusion of alteplase), stratified by centre and baseline stroke severity. The primary outcome was the proportion of patients with excellent outcome (ie, an mRS score of 0—1, or 2 if premorbid score was 2) at 90 days, analysed in the target population (all randomly assigned patients who had been correctly diagnosed with ischaemic stroke and had begun study medication). The study is registered with ClinicalTrials.gov, numberNCT00860366.

Findings

Between July 1, 2011, and April 30, 2013, we randomly assigned 421 patients, of whom 411 (98%) were included in the target population (211 received uric acid and 200 received placebo). 83 (39%) patients who received uric acid and 66 (33%) patients who received placebo had an excellent outcome (adjusted risk ratio 1·23 [95% CI 0·96—1·56]; p=0·099). No clinically relevant or statistically significant differences were reported between groups with respect to death (28 [13%] patients who received uric acidvs 31 [16%] who received placebo), symptomatic intracerebral haemorrhage (nine [4%] vs six [3%]), and gouty arthritis (one [<1%]vs four [2%]). 516 adverse events occurred in the uric acid group and 532 in the placebo group, of which 61 (12%) and 67 (13%), respectively, were serious adverse events (p=0·703).

Interpretation

The addition of uric acid to thrombolytic therapy did not increase the proportion of patients who achieved excellent outcome after stroke compared with placebo, but it did not lead to any safety concerns.

Aquí el enlace a la publicación original.
Programa preliminar de la reunión GENCI 2013
PROGRAMA PRELIMINAR REUNIÓN DEL GRUPO DE ESTUDIO DE NEUROLOGÍA CRÍTICA E INTENSIVISTA (GENCI)

Como coordinador del GENCI, me gustaría invitaros a la jornada del grupo que como cada año hemos preparado en el seno de la próxima reunión de la SEN. Adjunto el programa preliminar, que pienso puede ser del agrado de todos los interesados en la patología neurocrítica. Los ponentes son tanto neurólogos como neurocirujanos y anestesistas con experiencia en pacientes neurológicos. La mañana comenzará con cuatro temas controvertidos en la atención al paciente neurocrítico y la segunda parte consistirá en dos debates con formato A favor vs En contra sobre patología hemorrágica cerebral.

Salvo cambios de última hora el día es el viernes 22 de Noviembre y el lugar la Sala A del Palau de Congressos, Barcelona. Esperamos veros allí. 



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