Mitsias PD et al. (2005) MRI-guided, open trial of abciximab for ischemic stroke within a 3- to 24-hour window. Neurology 65: 612–615

Abciximab could have beneficial effects on neurological status and size of ischemic lesions in patients with ischemic stroke, an MRI-guided trial has shown.

Abciximab is a glycoprotein IIb/IIIa receptor antagonist previously shown to induce thrombolysis and restore vessel patency in patients with acute coronary syndromes who receive coronary stents.

Mitsias and colleagues recruited 29 patients with supratentorial stroke to take part in a single-center, open-label trial. Trial participants received abciximab therapy within 3–24 h of stroke onset. Following treatment, patients were monitored for bleeding and changes in hemoglobin levels, hematocrit and platelet count. Neurological deterioration was also measured at regular intervals using the NATIONAL INSTITUTES OF HEALTH STROKE SCALE (NIHSS). Post-treatment primary outcome measures were changes in NIHSS scores at 48–72 hours and ischemic lesion size on diffusion-weighted imaging at 24-hour follow-up.

NIHSS scores decreased for most patients after abciximab therapy, indicating that their neurological status had improved. Furthermore, there was a reduction in the size of ischemic lesions in 27% of patients. No treatment-related deaths, symptomatic intracranial hemorrhages or major systemic hemorrhages were observed.

Despite the small number of patients and uncontrolled nature of this study, the authors conclude that abciximab is relatively safe when used to treat patients with ischemic stroke within a 3–24-hour window, and that the drug could attenuate both neurological deterioration and ischemic lesion growth.