ATTI DELLA VIDEOCONFERENZA - 5 ottobre 1996
EMORRAGIA SUBARACNOIDEA: UN APPROCCIO PLURISPECIALISTICO - II  PROCEEDINGS OF THE VIDEOCONFERENCE - October 5, 1996
SUBARACHNOID HEMORRHAGE: A MULTIDISCIPLINARY APPROACH - II Free

Minerva Anestesiologica 1998 May;64(5):225-7

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: Italian

Steroids and tirilazad mesylate in SAH-patients

Tommasino C. ¹, Picozzi P. ²

¹ Istituto Scientifico Ospedale H S. Raffaele - Milano, Istituto di Anestesiologia e Rianimazione; ² USSL n. 34 - Legnano (Milano), Dipartimento di Neurochirurgia

Tirilazad mesylate, a nonglucocorticoid 21-aminosteroid, has been used in two randomized, double-blind, vehicle-controlled trials in Europe, Australia, New Zealand, and in North America in patients with aneurysmal subarachnoid hemorrage. The first trial has been concluded, enrolled 1023 patients, and demonstrated a dramatic reduction in mortality from 27% to 3% (p=0.01) in males receiving 6 mg/kg/day tirilazad for 10 days, when compared to vehicle-treated patients. There was also a less incidence of symptomatic vasospasm, and the frequency of hypertensive-hypervolemic-hemodilution therapy was significantly reduced. The reduction in mortality rate was remarkable, however the benefits of treatment with tirilazad were predominantly shown in men rather than in women. This clinical trial suggest that tirilazad mesylate, at a dosage of 6 mg/kg/day, improves overall outcome in aneurysmal subarachnoid hemorrhage pa-tients. Further data from the North America trial and the trial in women receiving higher doses of tirilazad are still pending.