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Evaluation of the efficacy and tolerability of naftidrofuryl in the therapy of chronic cerebral ischemia

https://doi.org/10.14412/2074-2711-2021-1-38-43

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Abstract

Objective: to study the clinical efficacy and tolerability of naftidrofuryl (Duzofarm®) in patients with chronic cerebral ischemia (CCI).

Patients and methods. A prospective open-label multicenter observational study evaluated the clinical efficiency and tolerability of naftidrofuryl treatment in patients with CCI. To statistically evaluate the efficacy and tolerability of naftidrofuryl, the investigators used data from 200 outpatients with Stages I–II CCI who were included in the program of treatment and received its full cycle. The patients were prescribed naftidrofuryl at a dose of 100 mg (2 tablets) thrice daily. Basic therapy that the patients had received before their inclusion in the observation program was not discontinued. The patients' status was evaluated using a specially designed questionnaire. Four visits were scheduled. All the patients underwent neurological examination. To study the patients' cognitive functions and emotional state, the investigators used the following tests and scales: the Mini-Cog test, the Mini-Mental State Examination (MMSE), the Zung Self-Rating Anxiety Scale, the Asthenia Subjective Assessment Scale, and the Modified Scoring Scale for Subjective Sleep Characteristics. Adverse reactions were recorded to evaluate the tolerability of therapy.

Results and discussion. Naftidrofuryl therapy significantly improved health and reversed complaints in the patients. By the end of the treatment cycle, there was a significant improvement on all scales, which suggested a decrease in the severity of cognitive impairment and asthenic and mild anxiety disorders. When performing the Mini-Cog test, the proportion of patients who were able to remember and recall three words without errors increased from 43 to 86%, and when doing the clock drawing test, the proportion increased by 65%. Cognitive functions on the MMSE were observed to statistically significantly improve by 1.2 scores. According to the Zung Anxiety Self-Rating Scale, the number of patients with anxiety disorders decreased by 24%, those with insomnia significantly declined by 31% compared with the baseline level.

Conclusion. The findings showed the high efficiency and appropriateness of naftidrofuryl administration to patients with Stages I–II CCI and hypertension.

About the Authors

M. N. Dadasheva
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation

Marina Nikolaevna Dadasheva

61/2, Shchepkin St., Build. 1, Moscow 129110



I. A. Zolotovskaya
Samara State Medical University, Ministry of Health of Russia
Russian Federation
89, Chapaevskaya St., Samara 443099


R. V. Gorenkov
N.A. Semashko National Research Institute of Public Health; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
12, Vorontsovo Pole St., Build. 1, Moscow 105064
8, Trubetskaya St., Build. 2, Moscow 119991


K. N. Dadasheva
M.F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
61/2, Shchepkin St., Build. 1, Moscow 129110


D. I. Lebedeva
Tyumen State Medical University, Ministry of Health of Russia
Russian Federation
54, Odesskaya St., Tyumen 625023


References

1. Skvortsova VI, Stakhovskaya LV, Gudkova VV, Alekhin AV. Chronic insufficiency of cerebral circulation. In: Gusev EI, Konovalov AN, Skvortsova VI. Nevrologiya. Natsional'noye rukovodstvo [Neurology. The National Guidelance]. 2 nd ed. Moscow: GEOTARMedia; 2017 (In Russ.).

2. Nour M, Scalzo F, Liebeskind DS. Ischemia-reperfusion injury in stroke. Interv Neurol. 2013 Sep;1(3-4):185-99. doi: 10.1159/000353125

3. Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging. Lancet Neurol. 2013 May;12(5):483-97. doi: 10.1016/S1474-4422(13)70060-7

4. Mok V, Kim J. Prevention and Management of Cerebral Small Vessel Disease. J Stroke. 2015 May;17(2):111-22. doi: 10.5853/jos.2015.17.2.111. Epub 2015 May 29.

5. Bath PM, Wardlaw J. Pharmacological treatment and prevention of cerebral small vessel disease. Int J Stroke. 2015 Jun;10(4):469-78. doi: 10.1111/ijs.12466. Epub 2015 Mar 2.

6. Zolotovskaja IA, Davydkin IL. Possibilities of pharmacological correction of structural and functional changes in microcirculation under conditions of endothelial dysfunction in comorbid patients with stroke. Klinitsist. 2016;10(2):32-42. doi: 10.17650/1818-83382016-10-2-32-42 (In Russ.).

7. Feinstein AR. Pre-therapeutic classification of co-morbidity in chronic disease. J Chron Dis. 1970 Dec;23(7):455-68. doi: 10.1016/00219681(70)90054-8

8. Litvinenko IV, Naumov KM, Odinak MM. Correction of cognitive and non-cognitive symptoms of cerebrovascular disease. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2014;114(4):35-40 (In Russ.).

9. Lokshina AB, Zakharov VV. Practical algorithms for managing patients with chronic cerebral ischemia. Effektivnaya farmakoterapiya. 2019;15(19):24-8. doi: 10.33978/2307-35862019-15-19-24-28 (In Russ.).

10. Dadasheva MN, Agafonov BV, Taranenko NYu. Innovative therapy of cerebrovascular diseases in patients with variable arterial hypertension. Prakticheskaya medicina. 2015;5(90):181-4 (In Russ.).

11. Kamchatnov PR, Mihailova NA. Possibilities of using the drug Duzopharm in patients with cerebrovascular diseases. Medicinskii alfavit. 2016;2(14):44-8 (In Russ.).

12. Parfenov VA, Lokshina AB, Grishina DA, et al. The use of naftidrofuril for moderate vascular cognitive impairment. Meditsinskij Sovet. 2017;(1S):22-6. doi: 10.21518/2079-701X2017-0-22-26 (In Russ.).

13. Belova AN, Shakurova DN, Gayazova EV. Possibilities of using naftidrofuryl in the therapy of cerebrovascular diseases: Literature review and the authors' observations. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(4):110-5. doi: 10.14412/2074-2711-2015-4-110-115 (In Russ.).

14. Le Poncin-Lafitte M, Grosdemouge C, Roy-Billon C, et al. Effects of naftidrofuryl on cerebral hemodynamics. metabolism and function after a retracted ischaemia. Arch Int Pharmacodyn Ther. 1982 Dec;260(2):218-29.

15. Louis JC. Effect of naftidrofuryl on metabolism and survival of cultured neurons. Neurochem Res. 1989 Dec;14(12):1195-201. doi: 10.1007/BF00965509

16. Zander JF, Aarhus LL, Katusic ZS, et al. Effects of naftidrofuryl on adrenergic nerves, endothelium and smooth muscle inisolated canine blood vessels. J Pharmacol Exp Ther. 1986 Dec;239(3):760-7.

17. Herrmann KS, Grosse-Heitmeyer A, Kreuzer H. Antithrombotic efficacy and its time course after application of naftidrofuryl in vivo. Arch Int Pharmacodyn Ther. 1986 Nov;284(1):145-54.

18. Takeo S, Tanonaka R, Miyake K, et al. Naftidrofuryl oxalate improves impaired brain glucose metabolism after induced cerebral metabolism in rats. J Pharmacol Exp Ther. 1991 Apr;257(1):404-10.

19. Wiernsperger NF. Serotonin, 5-HT2 receptors, and their blockade by naftidrofuryl: a targeted therapy of vascular disease. J Cardiovasc Pharmacol. 1994;23 Suppl 3:S37-43.

20. Trusova NA, Levina NO, Levin OS. Encephalopathy – Letzte wiese domestic angioneurology. Sovremennaya terapiya v psihiatrii i nevrologii. 2016;(2):10-7 (In Russ.).


For citation:


Dadasheva M.N., Zolotovskaya I.A., Gorenkov R.V., Dadasheva K.N., Lebedeva D.I. Evaluation of the efficacy and tolerability of naftidrofuryl in the therapy of chronic cerebral ischemia. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):38-43. (In Russ.) https://doi.org/10.14412/2074-2711-2021-1-38-43

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)