Magnesium Not Beneficial in Improving Disability Outcomes in Acute Stroke | Journal Scan
In patients with acute stroke, what is the impact of magnesium sulfate administered within 2 hours after the onset of symptoms on subsequent functional outcomes?
This was a multicenter, randomized, double-blind, placebo-controlled trial. Eligible patients had a suspected stroke as determined with the use of the modified Los Angeles Prehospital Stroke Screen, and received treatment within 2 hours of symptom onset. Magnesium sulfate or matching placebo was administered intravenously as a 15-minute bolus infusion, followed by a 24-hour maintenance infusion. The degree of disability, as assessed by the modified Rankin scale, was the primary outcome.
A total of 1,700 patients were randomized (857 in the magnesium group and 843 in the placebo group). There was no significant difference in 90-day disability between the placebo and magnesium groups (p = 0.28). There was also no difference in adverse events between the magnesium and placebo groups.
Although administration of magnesium sulfate within 2 hours of symptom onset in stroke was safe, it was not associated with improved functional outcomes at 90 days.
While it has been suggested that magnesium may exert a neuroprotective effect in animal models of stroke, the current analysis demonstrates that early administration of magnesium did not reduce disability at 90 days. The execution of the trial does offer valuable lessons in the efficient delivery of a study agent in a population of patients with acute stroke.
Keywords: Stroke, Brain Ischemia, Magnesium, Magnesium Sulfate, Neuroprotective Agents, Double-Blind Method
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