The effectiveness of Mexidol in patients of different age groups with chronic brain ischemia with cognitive disorders (the results of subanalysis of the international multicenter randomized double blind placebo-controlled study of memes)

Authors:
V.V. Zakharov ¹ , O.N. Tkacheva ^{2, 3} , E.A. Mkhitaryan ^{2, 3} , A.I. Fedin ²

¹ FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
² FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
³ Russian gerontological scientific and clinical center of the FGAOU in the Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
S.S. KORSAKOV JOURNAL OF NEUROLOGY AND PSYCHIATRY, 2022, Vol. 122, No. 11, Issue 2

Abstract:
Study objective. To evaluate the efficacy of sequential therapy with Mexidol and Mexidol FORTE 250 compared to placebo in patients with chronic cerebral ischemia (CCI) of different age subgroups.

Material and methods. This paper presents a subanalysis of data from the international, multicenter, randomized, double-blind, placebo-controlled MEMO study, which enrolled 318 patients (25% men) aged 40 to 90 (median 60) years. Treatment efficacy was assessed in three age groups: 40–60 (n=163), 61–75 (n=141), and 76–90 (n=13) years. The primary efficacy endpoint was the dynamic increase in the MoCA score as the absolute difference between the score before treatment and on day 75 of therapy. The dynamics of the total scores for the following questionnaires and scales were considered as secondary efficacy endpoints: the Digit Symbol Substitution Test, the SF-36 Quality of Life Questionnaire, the MFI-20 Subjective Asthenia Rating Scale, the Wein Autonomic Disorders Questionnaire, the Beck Anxiety Inventory, and the Tinetti Motor Activity Scale.

Results. Positive dynamics in the severity of cognitive, emotional, and motor impairments in the 40-60 and 61-75 year-old groups after 75 days of therapy were observed in patients receiving both Mexidol and placebo. However, these changes were more pronounced in patients receiving Mexidol, as indicated by higher values ​​of the median absolute difference in the total scores of the studied parameters.

Conclusion. The study results showed that patients with chronic cerebral ischemia (CCI) experienced significantly greater improvements in cognitive and motor function, improved quality of life, and reduced severity of autonomic dysfunction, asthenia, and anxiety after 75 days of treatment with Mexidol compared to placebo. These results support the use of Mexidol in the treatment of patients of all ages with CCI.

Key words: cognitive impairment, chronic cerebral ischemia, Mexidol, Mexidol FORTE 250, ethylmethylhydroxypyridine succinate, MEMO study.