Efficacy of Mexidol in patients with chronic brain ischemia and cognitive impairment of different age groups (results of sub-analysis of the international multicenter, randomized, double-blind, placebo-controlled study of sequential therapy in patients with chronic brain ischemia MEMO)
Author:
V.V. ZAKHAROV1, O.N. TKACHEVA2,3, E.A. MKHITARYAN2,3, A.I. FEDIN2
1Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2Pirogov Russian National Research Medical University , Moscow, Russia;
3Russian Clinical and Research Center of Gerontology, Pirogov Russian National Research Medical University , Moscow, Russia
Summary:
Objective. To assess the efficacy of sequential therapy with Mexidol and Mexidol FORTE 250 in comparison with placebo in patients of different age groups with chronic brain ischemia. Material and methods. The study is sub-analysis of data of the international multicenter, randomized, double-blind, placebo-controlled study of sequential therapy in patients with chronic brain ischemia (MEMO), which included 318 patients (25% men) in the age of 40—90 (median 60) years. All subjects were subdivided into 3 age subgroups: 40—60 years (n=163), 61—75 years (n=141) and 76—90 years (n=13). The primary efficacy endpoint was the dynamic of increase of total score by MoCA scale, i.e. the absolute value of difference by MoCA scale at the point of day 75 comparing to values before treatment. As secondary efficacy endpoints results of dynamic by following questionnaires and scales were used: digit symbol substitution test, the Health Survey SF-36, asthenia subjective assessment scale (MFI-20), Vane questionnaire, Beck anxiety scale, Tinetti scale. Results. After 75 days of treatment positive dynamic was revealed in cognitive, emotional and motor impairment in patients of 40—60 and 61—75 age subgroups both in groups of Mexidol and placebo, but in group of Mexidol the changes were more prominent which is proved by significantly higher values of median of absolute difference of total score of studied parameters. Conclusion. The results of trial showed that in patients of different age-subgroups with chronic brain ischemia the improvement in cognitive, motor impairment and quality of life, as well as decrease in vegetative impairment, asthenia and anxiety are observed after 75 days of treatment both in Mexidol and placebo group, but in Mexidol group these changes are more prominent. The data obtained confirm the expediency of the use of sequential therapy with Mexidol and Mexidol FORTE 250 in patients of different age subgroups with chronic brain ischemia. Keywords: cognitive impairment, chronic brain ischemia, Mexidol , Mexidol FORTE 250, ethylmethylhydroxypyridine succinate, MEMO trial.
Cognitive impairments in cardiological patients: diagnosis and prevention
This article is in "Library" - "Cardiology" section.
Author:
E.K. SHAVAROVA1,2, A.A. SHAVAROV1, R.E. AKHMETOV3, Z.D. KOBALAVA1,2
1Peoples Friendship University of Russia (RUDN University), Moscow, Russia;
2City Clinical Hospital named after V.V. Vinogradov, Moscow, Russia
3LLC «Scientific and production company «PHARMASOFT», Moscow, Russia
Use and outcomes of antioxidant therapy in ophthalmic practice
This article is in "Library" - "Ophthalmology" section.
Author:
A.B. MOVSISYAN1,2, ZH.G. OGANEZOVA2,3, E.A. EGOROV2
1Hospital for War Veterans No. 2, Moscow, Russia;
2Pirogov Russian National Research Medical University, Moscow, Russia;
3N.P. Bochkov Research Centre for Medical Genetics, Moscow, Russia
Use and outcomes of antioxidant therapy in ophthalmic practice
Author:
A.B. MOVSISYAN1,2, ZH.G. OGANEZOVA2,3, E.A. EGOROV2
1Hospital for War Veterans No. 2, Moscow, Russia;
2Pirogov Russian National Research Medical University, Moscow, Russia;
3N.P. Bochkov Research Centre for Medical Genetics, Moscow, Russia
Summary:
Advances in medical diagnostic technologies, particularly in ophthalmology, help researchers understand histological characteristics of the human eye and study vision at the cellular level. In addition to its role in the ocular function associated with the control of movements, senses and protective responses, the nervous system plays a key role in regulation of the visual process. Neurodegenerative disorders hold a special place among systemic diseases. Presently, the development of such pathologies are associated with neuroinflammation, which has been proven to also contribute to the glaucomatous process. For this reason, achieving target intraocular pressure does not always guarantee stabilization of the degenerative process. In this context, neuroprotective agents are recommended for glaucoma management to all patients taking into consideration pathogenetic characteristics of the disease. Based on its antioxidative and neuroprotective effects, ethylmethylhydroxypyridine succinate (Mexidol) is commonly used in ophthalmic practice, specifically in the treatment of patients with glaucomatous optic neuropathy and retinal diseases. The results of studies demonstrate that Mexidol is effective in slowing down neurodegeneration and stabilizing visual functions in patients with primary open-angle glaucoma due to its antihypoxic, antioxidant and membrane-stabilizing properties, as well as its positive impact on the neuromediator balance and ocular blood flow.
Keywords: ophthalmology, eye, neuroinflammation, glaucoma, glaucomatous optic neuropathy, neuroprotective therapy, ethylmethylhydroxypyridine succinate, Mexidol, Mexidol FORTE 250.
Cognitive impairments in cardiological patients: diagnosis and prevention
Author:
E.K. SHAVAROVA1,2, A.A. SHAVAROV1, R.E. AKHMETOV3, Z.D. KOBALAVA1,2
1Peoples Friendship University of Russia (RUDN University), Moscow, Russia;
2City Clinical Hospital named after V.V. Vinogradov, Moscow, Russia
3LLC «Scientific and production company «PHARMASOFT», Moscow, Russia
Summary:
The development of preventive measures to reduce the risk of developing cognitive decline is named by WHO among the main priorities of medicine. Cardiovascular diseases and cognitive disorders, on the one hand, have similar risk factors, such as obesity, smoking, dyslipidemia, lack of physical activity, low education level, and, on the other hand, the presence of atrial fibrillation (AF), arterial hypertension (AH), cardiac insufficiency (HF), chronic kidney disease, diabetes mellitus contributes to the progression of cognitive impairment. In the era of patient-oriented medicine, when choosing the optimal treatment regimen for AH, AF, and HF, it is necessary to take into account the potential of certain therapy regimens in the prevention of cognitive impairment. This article is devoted to a review of existing therapeutic strategies to prevent the development of cognitive deficits in patients with a cardiological profile.
Keywords: cognitive impairment, dementia, arterial hypertension, atrial fibrillation, heart failure, mexidol.
Safety of Mexidol® (ethylmethylhydroxypyridine succinate) in adult patients of different age groups
This article is in "Library" - "Chronic cerebrovascular disorder" section.
Author:
E.A. USHKALOVA1, S.K. ZYRYANOV1,2, O.I. BUTRANOVA1
1RUDN University, Moscow; 2City Clinical Hospital No. 24, Department of Healthcare of Moscow, Moscow
Safety of Mexidol® (ethylmethylhydroxypyridine succinate) in adult patients of different age groups
Author:
E.A. USHKALOVA1, S.K. ZYRYANOV1,2, O.I. BUTRANOVA1
1RUDN University, Moscow; 2City Clinical Hospital No. 24, Department of Healthcare of Moscow, Moscow
Summary:
To reduce the risk of developing adverse events (AEs) and increase the adherence of elderly patients to treatment, it is recommended to limit maximally the total number of prescribed drugs (DR), using one drug for the treatment of two or more pathologies if possible. The drugs that meet the criteria for use in elderly patients and / or patients with comorbidity include the original Russian drug Mexidol® (ethylmethylhydroxypyridine succinate), which has a multimodal mechanism of action and has multiple pharmacological effects. In order to study the safety of Mexidol in comparison with placebo in different age groups of patients with chronic cerebral ischemia, a post hoc analysis of the international multicenter, randomized, double-blind, placebo-controlled MEMO study with an adaptive design was carried out, which assessed the efficacy and safety of sequential therapy with Mexidol®, a solution for intravenous and intramuscular injection, 50 mg/ml (NPK PHARMASOFT, Russia) and Mexidol® FORTE 250 film-coated tablets, 250 mg (NPK PHARMASOFT, Russia) in patients with chronic cerebral ischemia. The study involved 318 patients aged from 40 to 90 years. Comparable safety and tolerability of Mexidol was demonstrated in middle-aged and elderly people with chronic cerebral ischemia, including patients over 75 years of age. Keywords: adult patients of different age groups; elderly; MEMO research; Mexidol®; Mexidol® FORTE 250; ethylmethylhydroxypyridine succinate; safety.
The role of oxidative stress in hemorrhagic stroke and restorative effects of Mexidol
Author:
T.A. VORONINA, V.A. KRAINEVA, N.N. ZOLOTOV, S.O. KOTEL’NIKOVA, E.A. VAL’DMAN
Zakusov Institute of Pharmacology, Moscow, Russia
Summary:
Objective. Identification of the role of oxidative stress in the development of disorders that occur in hemorrhagic stroke (HS, post-traumatic intracerebral hematoma), and the study of the effects of Mexidol on neurological and cognitive deficits in HS with an analysis of the relationship between the therapeutic effects of the drug in HS with its antioxidant effect. Material and methods. The study was carried out on mature outbred male rats weighing 260—280 g. HS was created by destruction of the brain tissue in the area of the capsula interna, with the introduction of blood into the site of injury. On the 1st, 7th, and 14th days after HS modeling, death, neurological deficits (McGrow scale, rotating rod), convulsive manifestations, and cognitive impairment were recorded in rats; blood plasma and homogenates of the cerebral cortex of rats. Mexidol was administered after the HS operation: first at a dose of 150 mg/kg, intraperitoneally, for 3 days and then 75 mg/kg, orally (from the 4th to the 14th day). Results. Mexidol in rats with HS significantly increases the survival rate of animals, reduces the manifestations of neurological deficits according to the McGrow scale (playpen movements, paresis of 1—4 limbs, paralysis of the lower limbs, lateral position), eliminates individual motor convulsive manifestations, restores impaired coordination of movements (rotating rod test) and improves, impaired HS, learning and memory processes. Mexidol normalizes the concentration of TBA-active products in the blood of animals and homogenates of the cerebral cortex of rats, both a day and 7 days after HS modeling. Conclusion. The data obtained indicate the involvement of oxidative stress as a chain of pathogenesis in the development of disorders in HS and the ability of Mexidol to alleviate neurological deficits, convulsive manifestations and cognitive impairment in HS, which is accompanied by a decrease in oxidative stress. All this justifies the importance of the use of Mexidol in patients with hemorrhagic stroke, posttraumatic intracerebral hematoma and determines the features of its therapeutic effects.
Keywords: hemorrhagic stroke, intracerebral hematoma, oxidative stress, Mexidol, neurological deficit, seizures, cognitive impairment.
Hypoxia and oxidative stress in cerebral circulation insufficiency — effective ways of correction
Author:
E.I. CHUKANOVA, A.S. CHUKANOVA, D.M. RODIONOVA
Pirogov Russian National Research Medical University, Moscow, Russia
Summary:
Cerebrovascular diseases (CVDs) are one of the urgent problems of clinical neurology and the second most common cause of dementia. Vascular factors leading to the development of hypoxia, oxidative stress, mitochondrial, endothelial dysfunction and, ultimately, to the development of apoptosis with the formation of degenerative brain changes are considered among the main risk factors for the development of CVD. The most important mechanisms of the development of TFR are hypoxia and oxidative stress, which indicate the need for the use of drugs with antihypoxant and antioxidant activity. Such drugs include Mexidol (ethylmethylhydroxypyridine succinate). Mexidol directly affects the pathogenetic factors of the formation of ischemic-hypoxic brain damage, has a high clinical efficacy in the treatment of various forms of cerebral circulatory insufficiency. Keywords: chronic cerebrovascular insufficiency, hypoxia, oxidative stress, vascular cognitive impairment, endothelial dysfunction, Mexidol.
The role of oxidative stress in hemorrhagic stroke and restorative effects of Mexidol
This article is in "Library" - "Pre-clinical & experimental studies" section.
Author:
T.A. VORONINA, V.A. KRAINEVA, N.N. ZOLOTOV, S.O. KOTEL’NIKOVA, E.A. VAL’DMAN
Zakusov Institute of Pharmacology, Moscow, Russia