Methodology: 4/5
Usefulness: 4/5
Christenson J, et al. Lancet. 2025 Feb 15;405(10478):571-582. doi: 10.1016/S0140-6736(25)00193-X.ย
Question and Methods: Double-blind, placebo-controlled RCT to determine if prehospital administration of nerinetide for suspected acute ischemic stroke improved functional outcomes at 90 days.
Findings: There was no significant difference in functional outcomes at 90 days between the experimental and control groups of this study. However, subgroup analysis signalled that in patients with confirmed ischemic stroke receiving reperfusion therapy, those receiving nerinetide had statistically significant improved outcomes.
Limitations: The major limitations of this study were:
ยท Inclusion of patients without acute ischaemic stroke reduced power.
ยท Imbalance in stroke severity between groups (worse in nerinetide group).
Interpretation: Currently, there is no role for nerinetide in suspected acute ischemic stroke. However, based on this trial and a subsequently performed meta-analysis using pooled nerinetide data, there may be a role in cases of confirmed acute ischemic stroke.
JC Supervisor: Dr. Jeff Perry
