By Matthew E. Fink, MD

Professor and Chairman, Department of Neurology, Weill Cornell Medical College; Neurologist-in-Chief, New York Presbyterian Hospital

Dr. Fink reports he is a retained consultant for Procter & Gamble and Pfizer.

SOURCES: Ziganshina LE, Abakumova, Vernay L. Cerebrolysin for acute ischemic stroke – Cochrane Corner. Stroke 2017;48:e245-e246.

Bereczki D. Hope dies last – Evidence again fails to support a neuroprotectant: Cerebrolysin for acute ischemic stroke. Stroke 2017;48:2343-2344.

A personal note: I have directed a neurology symposium in Salzburg, Austria, for the past 10 years, and it is attended each year by 30 to 40 neurologists from Eastern Europe and Asia. Every year, as I discuss stroke treatment, the participants bring up the use of Cerebrolysin, which is approved as standard therapy in many Eastern European and Asian countries. The question is always, “Why don’t you use Cerebrolysin in the United States?”

Cerebrolysin is a mixture of low molecular weight peptides and amino acids derived from pig’s brain, and has been used widely in the treatment of acute ischemic stroke in Russia, Eastern Europe, China, and other Asian countries. A recent Cochrane Review based on six trials in the published literature concluded that the use of Cerebrolysin has no effect on fatality. In addition, none of the trials demonstrated improvements in neurological or functional outcome, including a recent trial from China, as well as a large trial of 1,000 patients in Asia. None of the trials reported have shown any significant effect on death or disability, and the routine use of Cerebrolysin in acute stroke is not justified.