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ID 115570
タイトル別表記
MEDICAL TREATMENT OF UNRUPTURED CEREBRAL ANEURYSMS
著者
木内, 智也 Tokushima University
松下, 展久 Tokushima University
Yamaguchi, Tadashi Tokushima University
高麗, 雅章 Tokushima University
Okayama, Yoshihiro Tokushima University
Kitazato, Keiko T. Tokushima University
キーワード
Mineralocorticoid receptor blocker
eplerenone
hypertension
unruptured cerebral aneurysms
資料タイプ
学術雑誌論文
抄録
Background: Currently there are no pharmacological therapies for patients with unruptured cerebral aneurysms. Elsewhere we showed that the mineralocorticoid receptor antagonist eplerenone prevented the formation of cerebral aneurysms in our ovariectomized hypertensive aneurysm rat model. The current pilot study evaluated whether it can be used to prevent the growth and rupture of cerebral aneurysms in hypertensive patients. Methods: Between August 2011 and May 2014, we enrolled 82 patients with 90 aneurysms in an open-label uncontrolled clinical trial. All provided prior informed consent for inclusion in this study, and all were treated with eplerenone (25-100 mg/d). The primary end points of our study were the rupture and enlargement of the cerebral aneurysms. Results: Of the 82 patients, 80 (88 unruptured aneurysms) were followed for a mean of 21.3 months (153.4 aneurysm-years); 12 patients (15.0%) permanently discontinued taking the drug. One month after the start of eplerenone administration and throughout the follow-up period, eplerenone kept the blood pressure within the normal range. Most notably, no aneurysms smaller than 9 mm ruptured or enlarged. However, of 2 large thrombosed aneurysms, 1 enlarged and the other ruptured. The overall annual rupture rate was .65%; it was 13.16% for aneurysms larger than 10 mm; the overall annual rate for reaching the primary end points was 1.30%. Conclusion: Our observations suggest that eplerenone may help to prevent the growth and rupture of unruptured cerebral aneurysms smaller than 9 mm. To assess its potential long-term clinical benefits, large clinical trials are needed.
掲載誌名
Journal of Stroke and Cerebrovascular Diseases
ISSN
10523057
cat書誌ID
AA11543284
出版者
Elsevier|National Stroke Association
27
8
開始ページ
2134
終了ページ
2140
発行日
2018-04-02
権利情報
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系