| New recommendation | Brain cytoprotection with edaravone dexborneol (intravenous 37.5 mg/dose, once every 12 hours, for 14 days) may improve clinical outcomes in patients with AIS. | IIa | B |
| Preclinical and clinical studies suggest that edaravone can reduce the incidence of complications such as haemorrhagic transformation, progressive stroke, epilepsy and pulmonary infection in patients with IS. The RESCUE-Japan Registry study subgroup analysis found that the combination of intravenous rt-PA with edaravone was more effective in obtaining favourable outcomes in patients with AIS with LVO.96 Edaravone dexborneol, comprised of two active ingredients, edaravone and (+)−borneol, has been developed as a novel neuroprotective agent with synergistic antioxidant and anti-inflammatory effects in animal models. The TASTE study is a multicentre, randomised, double-blind, comparative, phase III clinical trial conducted at 48 hospitals in China to investigate the effects of edaravone dexborneol versus edaravone on 90-day functional outcomes in patients with AIS. The results indicated that when edaravone dexborneol versus edaravone was administered within 48 hours after AIS, 90-day good functional outcomes favoured the edaravone dexborneol group, especially in female patients (mRS score ≤1, 67.18% vs 58.97%, OR 1.42, 95% CI 1.12 to 1.81, p=0.004).97
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| New recommendation | NBP, 25 mg, dissolved in 100 mL sodium chloride and given as intravenous injection two times per day for the first 14 days, followed by soft 0.2 g capsules of NBP three times a day for the next 76 days, may serve as an adjunct treatment to reperfusion therapy and have the potential to improve functional outcomes in patients with AIS. | IIb | B |
| The BAST trial, a multicentre, double-blind, placebo-controlled, parallel randomised clinical trial, aimed to investigate whether treatment with NBP adjunctive to reperfusion therapy of intravenous thrombolysis and/or IA MT could improve the functional outcome in patients with AIS compared with placebo. The results showed that the proportion of patients achieving a favourable outcome based on the 90-day mRS score was significantly higher in the NBP group compared with the placebo group (56.7% vs 44.0%, OR 1.70, 95% CI 1.35 to 2.14, p<0.001). The rate of serious adverse events was similar between the two groups.98
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