The effectiveness and safety of the drug Mexidol Fort 250 in the framework of prolonged consistent therapy in patients with ischemic stroke in a carotide pool

Authors:

I.A. STRELNIKOVA¹, A.A. SVETKINA^1,2, O.V. ANDROFAGINA¹

¹State Budgetary Healthcare Institution "Samara Regional Clinical Hospital named after V.D. Seredavin" of the Ministry of Health of the Samara Region, Samara, Russia;
²Federal State Budgetary Educational Institution of Higher Education "Samara State Medical University" of the Ministry of Health of the Russian Federation, Samara, Russia

Place of publication:
S.S. KORSAKOV JOURNAL OF NEUROLOGY AND PSYCHIATRY, 2020, Vol. 120, No. 3, Issue 2

Abstract:
Objective. To evaluate the efficacy and safety of long-term sequential therapy with Mexidol and Mexidol Forte 250 on functional outcome in patients with ischemic stroke (IS) in the internal carotid artery system. Material and methods. The study included 50 patients with first-time IS in the carotid system who were hospitalized in the Regional Clinical Hospital on the first day from the onset of the disease. Patients in the main group (n=25) received Mexidol 500 mg intravenously by drip once a day for 14 days, then Mexidol Forte 250 tablets 250 mg 3 times a day for 60 days. Patients in the comparison group (n=25) received standard background therapy. The significance of intergroup differences was assessed using the Mann-Whitney test, Fisher's exact test, and relative risk (OR) calculation. Differences at the p level were considered statistically significant. Results. After 14 days of therapy, both groups of patients demonstrated positive dynamics compared to the initial parameters. Moreover, patients receiving Mexidol had a higher score on the MoCA scale (U=173.5, p=0.006), showed a lower score in performing tasks on dynamic praxis (U=214.0, p=0.028) and optical-spatial disorders (U=170.5, p=0.003), better memory strength (181.5, p=0.006), and also performed better in generalization tasks (U=200.5, p=0.014). By the 74th day, the absence of moderate cognitive impairment (MoCA>26 points) was diagnosed in 17 (68%) patients of the main group and 14 (56%) patients of the comparison group. Differences are not statistically significant. Moreover, patients in the main group had a statistically significantly lower score on the NIHSS scale (U=124.0, p<0.05) . Conclusion. Sequential therapy with Mexidol and Mexidol Forte 250 in the acute and early recovery periods of ischemic stroke has a positive effect on the regression of focal neurological symptoms, increases the likelihood of achieving independence in everyday life by 3.34 times, and helps reduce the severity of optical-spatial, neurodynamic and memory disorders. Key words: ischemic stroke, Mexidol, Mexidol Forte 250, cognitive impairment, functional outcome.