Updated Priorities for Cerebroprotection Trials.
Sean I Savitz1, Edgar A Samaniego2, David S Liebeskind3
1Institute for Stroke and Cerebrovascular Disease, UTHealth-Houston, TX (S.I.S.).
Stroke
|November 20, 2025
Summary
This workshop focused on improving acute stroke treatment trials. Key goals include preserving brain tissue, reducing infarct size, and using patient-centered outcomes to measure cerebroprotection effectiveness.
Area of Science:
- Neurology
- Clinical Trials
- Stroke Research
Background:
- Acute stroke treatment trials require optimized strategies to detect cerebroprotective effects.
- Hyperacute interventions aim to preserve penumbral tissue and limit infarct core expansion.
- Current outcome measures may not fully capture meaningful treatment benefits.
Purpose of the Study:
- To discuss critical aspects for designing impactful cerebroprotection trials in acute stroke.
- To identify optimal goals for hyperacute interventions.
- To recommend appropriate outcome measures for assessing treatment efficacy.
Main Methods:
- A STAIR XIII workshop convened experts to discuss trial design.
- Focus areas included treatment goals, imaging biomarkers, and clinical outcomes.
- Discussions synthesized current knowledge and future directions.
Main Results:
- Hyperacute cerebroprotection goals should prioritize preserving penumbral tissue and delaying infarct growth.
- Infarct volume is a key surrogate imaging marker for assessing treatment effects.
- Clinical outcomes should be domain-specific and patient-centered to detect meaningful changes.
Conclusions:
- Effective cerebroprotection trials in acute stroke require focused goals on tissue preservation and infarct limitation.
- Utilizing infarct volume as a surrogate marker is crucial for evaluating treatment impact.
- Incorporating patient-centered outcomes enhances the detection of clinically meaningful benefits.
