Intravenous Glibenclamide Reduces Lesional Water Uptake in Large Hemispheric Infarction.
Publication/Presentation Date
11-1-2019
Abstract
Background and Purpose- Prior studies have shown a linear relationship between computed tomography (CT)-derived radiodensity and water uptake, or brain edema, within stroke lesions. To test the hypothesis that intravenous glibenclamide (glyburide; BIIB093) reduces ischemic brain water uptake, we quantified the lesional net water uptake (NWU) on serial CT scans from patients enrolled in the phase 2 GAMES-RP Trial (Glyburide Advantage in Malignant Edema and Stroke). Methods- This was a post hoc exploratory analysis of the GAMES-RP study. Noncontrast CT scans performed between admission and day 7 (n=264) were analyzed in the GAMES-RP modified intention-to-treat sample. Quantitative change in CT radiodensity (ie, NWU) and midline shift (MLS) was measured. The gray and white matter NWU were also examined separately. Repeated-measures mixed-effects models were used to assess the effect of intravenous glibenclamide on MLS or NWU. Results- A median of 3 CT scans (interquartile range, 2-4) were performed per patient during the first 7 days after stroke. In a repeated-measures regression model, greater NWU was associated with increased MLS (β=0.23; 95% CI, 0.20-0.26;
Volume
50
Issue
11
First Page
3021
Last Page
3027
ISSN
1524-4628
Published In/Presented At
Vorasayan, P., Bevers, M. B., Beslow, L. A., Sze, G., Molyneaux, B. J., Hinson, H. E., Simard, J. M., von Kummer, R., Sheth, K. N., & Kimberly, W. T. (2019). Intravenous Glibenclamide Reduces Lesional Water Uptake in Large Hemispheric Infarction. Stroke, 50(11), 3021–3027. https://doi.org/10.1161/STROKEAHA.119.026036
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
31537189
Department(s)
Department of Pediatrics
Document Type
Article