title: Durability of the beneficial effect of MLC601 (NeuroAiD™) on functional recovery among stroke patients from the Philippines in the CHIMES and CHIMES-E studies.
abstract: Background and Aim A pre-specified country analysis of subjects from the Philippines in the CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) Study showed significantly improved functional and neurological outcomes on MLC601 at month (M) 3. We aimed to assess these effects on long-term functional recovery in the Filipino cohort. Methods The CHIMES-E (extension) Study evaluated subjects who completed three months of randomized placebo-controlled treatment in CHIMES up to two years. Blinding of treatment allocation was maintained and all subjects received standard stroke care and rehabilitation. Modified Rankin Score (mRS) and Barthel Index (BI) were assessed in-person at M3 and by telephone at M6, M12, M18, M24. Odds ratios (OR) with corresponding 95% confidence intervals (CI) for functional recovery using ordinal analysis of mRS and for achieving functional independence (mRS 0-1 or BI ≥ 95) at each time point were calculated, adjusting for age, sex, baseline National Institute of Health Stroke Scale (NIHSS), onset-to-treatment time (OTT) and pre-stroke mRS. Results The 378 subjects (MLC601 192, placebo 186) included in CHIMES-E from the Philippines (mean age 60.2 ± 11.1) had more women ( p < 0.001), worse baseline NIHSS ( p < 0.001) and longer onset to treatment time ( p = 0.002) compared to other countries. Baseline characteristics were similar between treatment groups. The treatment effect of MLC601 seen at M3 peaked at M6 with OR for mRS shift of 1.53 (95% CI 1.05-2.22), mRS dichotomy 0-1 of 1.77 (95% CI 1.10-2.83), and BI ≥ 95 of 1.87 (95% CI 1.16-3.02). The beneficial effect persisted up to M24. Conclusion The beneficial effect of MLC601 seen at M3 in the Filipino cohort is durable up to two years after stroke.
authors: 1 University of Santo Tomas Hospital, Manila, Philippines.
authors: Jose C
authors: JC
authors: Navarro
authors: 2 Department of Pharmacology, Clinical Research Centre, National University of Singapore, Singapore.
authors: Christopher Lh
authors: CL
authors: Chen
authors: 3 School of Public Health, The University of Hong Kong, Hong Kong.
authors: Chun F
authors: CF
authors: Lee
authors: 4 Jose Reyes Memorial Medical Center, Manila, Philippines.
authors: Herminigildo H
authors: HH
authors: Gan
authors: 5 Davao Medical School Foundation Hospital, San Pedro Hospital, Davao City, Philippines.
authors: Annabelle Y
authors: AY
authors: Lao
authors: 1 University of Santo Tomas Hospital, Manila, Philippines.
authors: Alejandro C
authors: AC
authors: Baroque
authors: 6 Baguio General Hospital and Medical Center, Baguio City, Philippines.
authors: John Harold B
authors: JH
authors: Hiyadan
authors: 7 Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors: Carlos L
authors: CL
authors: Chua
authors: 7 Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
authors: Ma Cristina
authors: MC
authors: San Jose
authors: 8 West Visayas State University Medical Center, Iloilo City, Philippines.
authors: Joel M
authors: JM
authors: Advincula
authors: 9 Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
authors: Narayanaswamy
authors: N
authors: Venketasubramanian
mesh_terms: D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D016017:Odds Ratio; D010679:Philippines; D020127:Recovery of Function / Q000187:drug effects; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal; C546417:Neuroaid; D018696:Neuroprotective Agents
keywords: MLC601; Philippines; acute stroke; clinical trial; long-term outcome; stroke recovery