Prehospital exenatide in hyperglycemic stroke-A randomized trial

Area of Science:

• Neurology
• Endocrinology
• Clinical Trials

Background:

• Hyperglycemia is a known predictor of poor stroke outcomes.
• Current treatments like insulin carry a risk of hypoglycemia.
• Glucagon-like peptide-1 receptor agonists (GLP-1RA) offer neuroprotection with a lower hypoglycemia risk.

Purpose of the Study:

• To determine if prehospital exenatide administration lowers plasma glucose in stroke patients.
• To assess the tolerability and safety of prehospital exenatide in stroke patients.

Main Methods:

• A randomized controlled trial compared prehospital exenatide to standard care for hyperglycemia in stroke patients.
• Patients with FAST score ≥1 and glucose ≥8 mmol/L were randomized.
• Plasma glucose was monitored for 24 hours, and adverse events were recorded.

Main Results:

• The study was stopped prematurely due to slow patient inclusion (19 randomized, 8 received exenatide).
• No significant difference in plasma glucose at 4 hours was observed between the exenatide and control groups (7.6 ± 1.6 vs 7.0 ± 1.9 mmol/L, P=0.56).
• No major adverse events were reported during the study.

Conclusions:

• Prehospital exenatide showed no effect on hyperglycemia in this limited, prematurely stopped trial.
• Exenatide was found to be safe and well-tolerated in the studied stroke patient population.