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Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial (2025)
Journal Article
Sluis, W. M., de Jonge, J. C., Reinink, H., Wilson, A., Woodhouse, L. J., Dawson, J., Lees, K. R., Bath, P. M., & van der Worp, H. B. (2025). Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial. European Stroke Journal, https://doi.org/10.1177/23969873251320207

Introduction:
The modified Rankin Scale (mRS) is the most frequently used primary outcome measure in acute stroke research despite significant interobserver variability in assigning grades. We assessed the use of central blinded adjudication of the... Read More about Impact of central adjudication of the score on the modified Rankin Scale in an international, randomized, acute stroke trial.

Non-inferiority trials in stroke research: what are they, and how should we interpret them? (2025)
Journal Article
Li, L., Lioutas, V.-A., Akyea, R. K., Gerner, S., Lau, K. K., Ramage, E., Katsanos, A. H., Howard, G., & Bath, P. M. (2025). Non-inferiority trials in stroke research: what are they, and how should we interpret them?. Journal of Stroke, 27(1), 41-51. https://doi.org/10.5853/jos.2024.03923

Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the “less traditional” designs that have gained increasing interest in the last decade is non-in... Read More about Non-inferiority trials in stroke research: what are they, and how should we interpret them?.

Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence (2025)
Journal Article
Kasner, S. E., Bath, P. M., Hill, M. D., Volpi, J. J., Giuffre, M., Masuoka, L., Wambeke, D., & Madeddu, P. R. (2025). Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence. Stroke, https://doi.org/10.1161/STROKEAHA.124.048858

Novel strategies are needed for the treatment of acute ischemic stroke when revascularization therapies are not clinically appropriate or are unsuccessful. Recombinant human tissue kallikrein-1 (rKLK1), a bradykinin-producing enzyme, offers a promis... Read More about Recombinant Human Tissue Kallikrein-1 for Treating Acute Ischemic Stroke and Preventing Recurrence.

Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis (2024)
Journal Article
Zhang, Y., Wang, X., Gao, Y., Chen, W., Johnston, S. C., Amarenco, P., Bath, P. M., Yan, H., Wang, T., Yang, Y., Zhou, Q., Wang, M., Jing, J., Wang, C., Wang, Y., Wang, Y., & Pan, Y. (2025). Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis. Stroke, 56(1), 46-55. https://doi.org/10.1161/strokeaha.124.049246

BACKGROUND: Risk profile of recurrence may influence the effect of antiplatelet therapy. This study aimed to evaluate the efficacy and safety of clopidogrel-aspirin initiated within 72 hours after symptom onset for acute mild stroke or high-risk tran... Read More about Dual Antiplatelet Treatment up to 72 Hours After Ischemic Stroke Stratified by Risk Profile: A Post Hoc Analysis.

Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing (2024)
Journal Article
M Bath, P., P Phan, E., Clay, G., Dawson, J., Malhotra, P., Howard, R., Pal, S., M Wardlaw, J., Quinn, T., & Macleod, M. (2024). Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing. F1000Research, 13, Article 1546. https://doi.org/10.12688/f1000research.157890.1

Background
Cerebral small vessel disease (cSVD) is a progressive neurovascular-degenerative condition without specific treatment that causes lacunar stroke, most intracerebral haemorrhage, vascular cognitive impairment (VCI) and several neuropsychia... Read More about Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing.

Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis (2024)
Journal Article
Yassi, N., Yogendrakumar, V., Churilov, L., Meretoja, A., Wu, T., Campbell, B. C., Strbian, D., Jeng, J.-S., Woodhouse, L. J., Ovesen, C., Law, Z. K., Gu, H.-Q., Nie, X., Liu, J., Ma, H. H., Zhao, H., Bath, P. M., Liu, L., Sprigg, N., Donnan, G. A., & Davis, S. M. (2024). Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis. Neurology, 103(12), https://doi.org/10.1212/wnl.0000000000210104

Background and Objectives The antifibrinolytic agent tranexamic acid has been tested in intracerebral hemorrhage trials with overall neutral results. Ongoing contrast extravasation on CT angiography (spot sign) can identify individuals with ongoing b... Read More about Tranexamic Acid Within 4.5 Hours of Intracerebral Hemorrhage With the CTA Spot Sign: Systematic Review and Individual Patient Meta-analysis.

Lessons from the PROTECT-CH COVID-19 platform trial in care homes (2024)
Journal Article
Bath, P. M., Ball, J., Boyd, M., Gage, H., Glover, M., Godfrey, M., Guthrie, B., Hewitt, J., Howard, R., Jaki, T., Juszczak, E., Lasserson, D., Leighton, P., Leyland, V., Shen Lim, W., Logan, P., Meakin, G., Montgomery, A., Ogollah, R., Passmore, P., …Gordon, A. L. (in press). Lessons from the PROTECT-CH COVID-19 platform trial in care homes. Health Technology Assessment,

Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial (2024)
Journal Article
Appleton, J. P., Dixon, M., Woodhouse, L. J., Anderson, C. S., Ankolekar, S., Cala, L., England, T. J., Godolphin, P. J., Krishnan, K., Mair, G., Muir, K. W., Potter, J., Price, C. I., Randall, M., Robinson, T. G., Roffe, C., Rothwell, P. M., Sandset, E. C., Saver, J. L., Siriwardena, A. N., …Bath, P. M. (2024). Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial. European Journal of Neurology, 31(12), Article e16502. https://doi.org/10.1111/ene.16502

Background and purpose
Ambulance trials assessing interventions in suspected stroke patients will recruit patients with currently active symptoms that will resolve into transient ischaemic attack (TIA). The safety and efficacy of glyceryl trinitrate... Read More about Pre‐hospital transdermal glyceryl trinitrate for transient ischaemic attack: Data from the RIGHT‐2 trial.

Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey (2024)
Journal Article
Katsanos, A. H., Lioutas, V. A., Yperzeele, L., Ullberg, T., Li, L., Ramage, E. R., Koltsov, I. A., Shapranova, J., Howard, G., Bath, P. M., & Khan, M. (2025). Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey. Journal of Stroke and Cerebrovascular Diseases, 34(1), Article 108132. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.108132

Introduction: The adoption of non-inferiority trial designs for assessing new interventions in stroke treatment is on the rise. We designed a survey to assess stroke specialists' understanding and familiarity with non-inferiority trials and margins.... Read More about Perception and acquaintance of stroke specialists on non-inferiority trials: An international survey.

Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack (2024)
Journal Article
Guan, L., Han, S., Johnston, S. C., Bath, P. M., Amarenco, P., Yang, Y., Wang, T., Jing, J., Wang, C., Gao, Y., Chen, W., Yan, H., Wang, X., Wang, Y., Wang, Y., & Pan, Y. (2024). Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack. Neurology, 103(7), https://doi.org/10.1212/wnl.0000000000209845

Background and ObjectivesClopidogrel-aspirin initiated within 72 hours of symptom onset is effective in patients with mild ischemic stroke or transient ischemic attack (TIA) in the Intensive Statin and Antiplatelet Therapy for Acute High-risk Intracr... Read More about Duration of Benefit and Risk of Dual Antiplatelet Therapy up to 72 Hours After Mild Ischemic Stroke and Transient Ischemic Attack.

Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group (2024)
Journal Article
Rakkar, K., Kadir, R. R. A., Othman, O. A., Sprigg, N., Bath, P. M., & Bayraktutan, U. (2024). Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group. Stem Cell Reviews and Reports, 20, 2336–2344. https://doi.org/10.1007/s12015-024-10777-5

Endothelial progenitor cells (EPCs) are stem cells that can repair injured blood vessels through neovascularisation. This is achieved through secretion of growth factors and endothelial maturation. EPC numbers and function have been studied to determ... Read More about Comorbidities and Angiogenic Regulators Affect Endothelial Progenitor Cell Subtype Numbers in a Healthy Volunteer Control Group.

Metoclopramide to Prevent Pneumonia in Patients With Stroke and a Nasogastric Tube: Data From the PRECIOUS Trial (2024)
Journal Article
Sluis, W. M., de Jonge, J. C., Reinink, H., Woodhouse, L. J., Westendorp, W. F., Bath, P. M., van de Beek, D., van der Worp, H. B., & for the PRECIOUS Investigators. (2024). Metoclopramide to Prevent Pneumonia in Patients With Stroke and a Nasogastric Tube: Data From the PRECIOUS Trial. Stroke, 55(10), 2402-2408. https://doi.org/10.1161/strokeaha.124.047582

BACKGROUND:
A randomized trial suggested that treatment with metoclopramide reduces the risk of pneumonia in patients with acute stroke and a nasogastric tube. We assessed whether this finding could be replicated in a post hoc analysis of the random... Read More about Metoclopramide to Prevent Pneumonia in Patients With Stroke and a Nasogastric Tube: Data From the PRECIOUS Trial.

Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial (2024)
Journal Article
Law, Z. K., Menon, C. S., Woodhouse, L. J., Appleton, J. P., Al-Shahi Salman, R., Robinson, T., Werring, D., Roffe, C., Dineen, R. A., Bath, P. M., & Sprigg, N. (2024). Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial. European Stroke Journal, https://doi.org/10.1177/23969873241265939

Introduction:
The Tranexamic acid for IntraCerebral Haemorrhage-2 (TICH-2) trial reported no significant improvement in death and dependency at day 90 despite reductions in haematoma expansion, early neurological deterioration and early death. Howev... Read More about Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial.

The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial (2024)
Journal Article
Hollingworth, M., Woodhouse, L. J., Law, Z. K., Ali, A., Krishnan, K., Dineen, R. A., Christensen, H., England, T. J., Roffe, C., Werring, D., Peters, N., Ciccone, A., Robinson, T., Członkowska, A., Bereczki, D., Egea-Guerrero, J. J., Ozturk, S., Bath, P. M., & Sprigg, N. (2024). The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial. Neurosurgery, 95(3), 605-616. https://doi.org/10.1227/neu.0000000000002961

BACKGROUND AND OBJECTIVES:
An important proportion of patients with spontaneous intracerebral hemorrhage (ICH) undergo neurosurgical intervention to reduce mass effect from large hematomas and control the complications of bleeding, including hemato... Read More about The Effect of Tranexamic Acid on Neurosurgical Intervention in Spontaneous Intracerebral Hematoma: Data From 121 Surgically Treated Participants From the Tranexamic Acid in IntraCerebral Hemorrhage-2 Randomized Controlled Trial.

Dysphagia after stroke: research advances in treatment interventions (2024)
Journal Article
Labeit, B., Michou, E., Trapl-Grundschober, M., Suntrup-Krueger, S., Muhle, P., Bath, P. M., & Dziewas, R. (2024). Dysphagia after stroke: research advances in treatment interventions. Lancet Neurology, 23(4), 418-428. https://doi.org/10.1016/s1474-4422%2824%2900053-x

After a stroke, most patients have dysphagia, which can lead to aspiration pneumonia, malnutrition, and adverse functional outcomes. Protective interventions aimed at reducing these complications remain the cornerstone of treatment. Dietary adjustmen... Read More about Dysphagia after stroke: research advances in treatment interventions.

Ninety‐Day Stroke Recurrence in Minor Stroke: Systematic Review and Meta‐Analysis of Trials and Observational Studies (2024)
Journal Article
Lim, A., Ma, H., Johnston, S. C., Singhal, S., Muthusamy, S., Wang, Y., Pan, Y., Coutts, S. B., Hill, M. D., Ois, A., Kapral, M. K., Knoflach, M., Woodhouse, L. J., Bath, P. M., & Phan, T. G. (2024). Ninety‐Day Stroke Recurrence in Minor Stroke: Systematic Review and Meta‐Analysis of Trials and Observational Studies. Journal of the American Heart Association, 13(9), Article e032471. https://doi.org/10.1161/jaha.123.032471

Background Risk of recurrence after minor ischemic stroke is usually reported with transient ischemic attack. No previous meta‐analysis has focused on minor ischemic stroke alone. The objective was to evaluate the pooled proportion of 90‐day stroke r... Read More about Ninety‐Day Stroke Recurrence in Minor Stroke: Systematic Review and Meta‐Analysis of Trials and Observational Studies.

Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2) (2024)
Journal Article
Blair, G., Appleton, J. P., Doubal, F. N., Mhlanga, I. I., Woodhouse, L. J., Bath, P. M., & Wardlaw, J. M. (2024). Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2). Stroke and Vascular Neurology, 9(6), Article e003022. https://doi.org/10.1136/svn-2023-003022

Cerebral small vessel disease (cSVD) causes lacunar stroke (25% of ischaemic strokes), haemorrhage, dementia, physical frailty, or is 'covert', but has no specific treatment. Uncertainties about the design of clinical trials in cSVD, which patients t... Read More about Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2).

Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST (2024)
Journal Article
MacDonald, A. S., McConnachie, A., Dickie, D. A., Bath, P. M., Forbes, K., Quinn, T., Broomfield, N. M., Dani, K., Doney, A., Muir, K. W., Struthers, A., Walters, M., Barber, M., Bhalla, A., Cameron, A., Guyler, P., Hassan, A., Kearney, M., Keegan, B., Lakshmanan, S., …Dawson, J. (2024). Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST. Journal of Human Hypertension, 38, 307-313. https://doi.org/10.1038/s41371-024-00906-5

Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and c... Read More about Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST.

Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration (2024)
Journal Article
Wang, X., Yang, J., Moullaali, T. J., Sandset, E. C., Woodhouse, L. J., Law, Z. K., Arima, H., Butcher, K. S., Delcourt, C., Mbbs, L. E., Gupta, S., Jiang, W., Koch, S., Potter, J., Qureshi, A. I., Robinson, T. G., Salman, R. A.-S., Saver, J. L., Sprigg, N., Wardlaw, J., …Chalmers, J. (2024). Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration. Stroke, 55(4), 849-855. https://doi.org/10.1161/STROKEAHA.123.044358

OBJECTIVE:
To investigate whether an earlier time to achieving and maintaining systolic blood pressure (SBP) at 120 to 140 mm Hg is associated with favorable outcomes in a cohort of patients with acute intracerebral hemorrhage.

METHODS:
We poole... Read More about Influence of Time to Achieve Target Systolic Blood Pressure on Outcome After Intracerebral Hemorrhage: The Blood Pressure in Acute Stroke Collaboration.