Centre for Clinical Brain Sciences

Drugs to prevent stroke and dementia show promise in early trial

May 2019: A clinical study led by CCBS researchers has found that two drugs are safe for use in stroke caused by damage to small blood vessels.

Our researchers have published the findings of the LACI-1 trial, which has tested two drugs in a type of stroke caused by damaged blood vessels in the brain, called lacunar stroke. The drugs, cilostazol and isosorbide mononitrate, are already used to treat other conditions, such as heart disease and angina, but have not been used before in the UK for the treatment of stroke or vascular dementia.

Damage to small blood vessels in the brain is responsible for around a quarter of strokes. It is also a common cause of memory problems and dementia.

A team led by the Universities of Edinburgh and Nottingham recruited 57 people who had experienced a lacunar stroke. Patients took the two medicines either individually or in combination for up to nine weeks, in addition to usual treatments aimed at preventing further strokes. They completed health questionnaires and had regular blood pressure checks, blood tests and brain scans.

The findings suggested that the drugs were safe for use in stroke patients. There were also signs that the treatments helped improve blood vessel function in the arms and brain, and may improve thinking skills.

A larger follow-up study, called LACI-2, is already underway.

We are delighted that the results of this trial show promise for treating a common cause of stroke and the commonest cause of vascular dementia, since currently there are no effective treatments. Further trials are underway.

Professor Joanna WardlawLead researcher on the study, Centre for Clinical Brain Sciences

The study was published in EClinicalMedicine. It was funded primarily by the Alzheimer’s Society, with support from the UK Stroke Association, British Heart Foundation, the European Union, National Institutes of Health Research, and NHS Research Scotland.

Related links

Read the publication: G.W Blair et al. Tolerability, safety and intermediary pharmacological effects of cilostazol and isosorbide mononitrate, alone and combined, in patients with lacunar ischaemic stroke: The LACunar Intervention-1 (LACI-1) Trial, a randomised clinical trial. EClinicalMedicine, 2019. DOI: doi.org/10.1016/j.eclinm.2019.04.001

Prof Joanna Wardlaw's profile

Brain vascular disease research at the Centre for Clinical Brain Sciences