Manfaat Citicoline pada Tata Laksana Stroke Iskemik
DOI:
https://doi.org/10.55175/cdk.v51i5.1056Kata Kunci:
Citicoline, gangguan elektrolit, stroke iskemikAbstrak
Latar belakang: Stroke merupakan penyakit paling umum ketiga setelah penyakit jantung dan kanker serta penyebab utama kecacatan di seluruh dunia. Jenis stroke yang paling umum, yaitu sekitar 85%-87% kasus, adalah stroke iskemik (SI). Tujuan laporan ini adalah untuk mengkaji manfaat citicoline pada pasien SI. Kasus: Laki-laki berusia 63 tahun masuk dengan diagnosis SI dan gangguan elektrolit. Tata laksana umum adalah posisi semi-fowler, oksigen, dan menjaga asupan cairan serta nutrisi. Tata laksana khusus adalah infus RL 20 tetes/menit, candesartan 1x16 mg, clopidogrel 1x75 mg, omeprazole 40 mg/24 jam intravena (IV), citicoline 500 mg/12 jam IV. Hasil perawatan menunjukkan perbaikan klinis. Metode: Pencarian artikel di PubMed, Cochrane, dan Google Scholar pada Februari-April 2022 untuk mendapat studi yang relevan. Hasilnya dievaluasi menggunakan kriteria inklusi dan eksklusi. Teks lengkap diperoleh dan ditinjau secara kritis dengan kedokteran berbasis bukti. Hasilnya dibatasi pada tinjauan sistematis dan meta-analisis. Hasil: Lima studi dianggap valid, penting, dan dapat diterapkan. Namun, kualitas studi bervariasi. Simpulan: Seluruh studi menunjukkan bahwa citicoline memiliki potensi meningkatkan hasil klinis pasien SI.
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Referensi
l. Mukherjee D, Patil CG. Epidemiology and the global burden of stroke. World Neurosurg. 2011;76 (suppl):85–90.
Feigin VL, Lawes CM, Bennett DA, Anderson CS. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet Neurol. 2003;2: 43–53.
Davalos A, Alvarez-Sabin J, Castillo J, Díez-Tejedor E, Ferro J, Martínez-Vila E, et al, for the International Citicoline Trial on Acute Stroke (ICTUS) Trial Investigators. Citicoline in the treatment of acute ischaemic stroke: an international, randomized, multicentre, placebo-controlled study (ICTUS trial). Lancet 2012;380:349–57.
Lees KR, Bluhmki E, von Kummer R, Brott TG, Toni D, Grotta JC, et al, and the ECASS, ATLANTIS, NINDS and EPITHET rt-PA Study Group. Time to treatment with intravenous alteplase and outcome in stroke: An updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 2010;375:1695–703.
Agarwal A, Vishnu VY, Sharma J, Bhatia R, Garg A, Dwivedi S, et al. Citicoline in acute ischemic stroke: A randomized controlled trial. PLoS ONE 2022;17(5):e0269224.
Secades JJ, Alvarez-Sabín J, Castillo J, Díez-Tejedor E, Martínez-Vila E, Ríos J, et al. Citicoline for acute ischemic stroke: A systematic review and formal meta-analysis of randomized, double-Blind, and placebo-controlled trials. J Stroke Cerebrovasc Dis. 2016;25(8):1984-96. DOI: 10.1016/j.jstrokecerebrovasdis.2016.04.010.
Sahota P, Savitz SI. Investigational therapies for ischemic stroke: Neuroprotection and neurorecovery. Neurotherapeutics 2011;8:434–51.
Saver JL. Target brain: Neuroprotection and neurorestoration in ischemic stroke. Rev Neurol Dis. 2010;7(suppl 1):14–21.
Da´valos A, Castillo J, Alvarez-Sabı´n J, Secades JJ, Mercadal J, Lopez S, et al. Oral citicoline in acute ischemic stroke: An individual patient data pooling analysis of clinical trials. Stroke 2002;33:2850–7.
Gutie´rrez-Ferna´ndez M, Rodrı´guez-Frutos B, Fuentes B, Vallejo-Cremades MT, Alvarez-Grech J, Expósito-Alcaide M, et al. CDP-choline treatment induces brain plasticity markers expression in experimental animal stroke. Neurochem Int. 2012;60:310–7.
Clark WM, Warach SJ, Pettigrew LC, Gammans RE, Sabounjian LA. A randomized dose-response trial of citicoline in acute ischemic stroke patients. Neurology 1997;49:671–78.
Clark WM, Williams BJ, Selzer KA, Zweifler RM, Sabounjian LA, Gammans RE. A randomized efficacy trial of citicoline in patients with acute ischemic stroke. Stroke 1999;30:2592–7.
Clark WM, Wechsler LR, Sabounjian LA, Schwiderski UE. A phase III randomized efficacy trial of 2000 mg citicoline in acute ischemic stroke patients. Neurology 2001;57:1595–602.
Herskovits AZ, Guarente LP. SIRT1 in neurodevelopment and brain senescence. Neuron 2014;81:471–83. DOI: 10.1016/j.neuron.2014.01.028.
Xu J, Jackson CW, Khoury N, Escobar I, Perez-Pinzon MA. Brain SIRT1 mediates metabolic homeostasis and neuroprotection. Front Endocrinol. 2018;9:702. DOI: 10.3389/fendo.2018.00702.
Bonda DJ, Lee HG, Camins A, Pallàs M, Casadesus G, Smith MA, et al. The sirtuin pathway in ageing and Alzheimer disease: Mechanistic and therapeutic considerations. Lancet Neurol. 2011;10:275–9. DOI: 10.1016/S1474-4422(11)70013-8.
Donmez G, Arun A, Chung CY, McLean PJ, Lindquist S, Guarente L. SIRT1 protects against α-synuclein aggregation by activating molecular chaperones. J Neurosci. 2012;32: 124–32. DOI: 10.1523/JNEUROSCI.3442-11.2012.
Hurtado O, Hernández-Jiménez M, Zarruk JG, Cuartero MI, Ballesteros I, Camarero G, et al. Citicoline (CDP-choline) increases sirtuin1 expression concomitant to neuroprotection in experimental stroke. J Neurochem. 2013;126:819–26. DOI: 10.1111/jnc.12269.
Secades JJ. Citicoline: Pharmacological and clinical review, 2016 update. Rev Neurol. 2016;63:1–73.
Synoradzki K, Grieb P. Citicoline: A superior form of choline? Nutrients 2019;11:1569. DOI: 10.3390/nu11071569.
Blusztajn JK, Slack BE, Mellott TJ. Neuroprotective actions of dietary choline. Nutrients 2017;9:815. DOI: 10.3390/nu9080815.
Roohi-Azizi M, Torkaman-Boutorabi A, Akhondzadeh S, Nejatisafa AA, Sadat-Shirazi MS, Zarrindast MR. Influence of citicoline on citalopram-induced antidepressant activity in depressive-like symptoms in male mice. Physiol Behav. 2018;195:151–7. DOI: 10.1016/j.physbeh.2018.08.002.
Hurtado O, Moro MA, Cárdenas A, Sanchez V, Fernández-Tomé P, Leza JC, et al. Neuroprotection afforded by prior citicoline administration in experimental brain ischemia: Effects on glutamate transport. Neurobiol Dis. 2005;18:336–45.
Jasielski P, Piędel F, Piwek M, Rocka A, Petit V, Rejdak K. Application of citicoline in neurological disorders: A systematic review. Nutrients 2020;12(10):3113. DOI: 10.3390/nu12103113.
Sharma A. How to write an article: An introduction to basic scientific medical writing. J Minim Access Surg. 2019;15(3):242-8. DOI: 10.4103/jmas.JMAS_91_18. =
Theola J, Hermanadi MI, Gibran K, Ihsan S. Clinical outcomes of ivermectin in Covid-19 treatment: An evidence-based case report from systemic reviews and meta-analyses. J Ilmiah Mahasiswa Kedokt Indon. 2021;9:2. DOI: 10.53366/jimki.v9i2.411.
Padhy BM, Mohanty RR, Das S, Meher BR. Therapeutic potential of ivermectin as add on treatment in COVID 19: A systematic review and meta-analysis. J Pharm Pharm Sci. 2020;23:462-9. DOI: 10.18433/jpps31457.
Martí-Carvajal AJ, Valli C, Martí-Amarista CE, Solà I, Martí-Fàbregas J, Bonfill Cosp X. Citicoline for treating people with acute ischemic stroke. Cochrane Database Syst Rev. 2020;8(8):CD013066. DOI: 10.1002/14651858.CD013066.pub2.
Sagaro GG, Amenta F. Choline-containing phospholipids in stroke treatment: A systematic review and meta-analysis. J Clin Med. 2023;12:2875.
Premi E, Cantoni V, Benussi A, Gilberti N, Vergani V, Delrio I, et al. Citicoline treatment in acute ischemic stroke: A randomized, single-blind TMS study. Front Neurol. 2022;13:915362. DOI: 10.3389/fneur.2022.915362.
Secades JJ, Alvarez-Sabín J, Rubio F, Lozano R, Dávalos A, Castillo J. Citicoline in intracerebral haemorrhage: A double blind, randomized, placebo controlled, multi-centre pilot study. Cerebrovasc Dis. 2006;21(5-6):380-5. DOI: 10.1159/000091547.
Alvarez-Sabín J, Román GC. The role of citicoline in neuroprotection and neurorepair in ischemic stroke. Brain Sci. 2013;3(3):1395-414. DOI: 10.3390/brainsci3031395.
Secades JJ, Gareri P. Citicoline: Pharmacological and clinical review, 2022 update. Rev Neurol. 2022;75 (Suppl. 5):0-89. DOI: 10.33588/rn.75S05.2022311.
Kanyal N. The science of ischemic stroke: Pathophysiology & pharmacological treatment. Int J Pharm Res Rev. 2015;4(10):65-84.
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Hak Cipta (c) 2024 endyjulianto, jekson Martiar Siahaan, 3Putri Chairani Eyanoer
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