Neuroprotection: at what cost, at what time, at what price?

Table 2.

Edaravonedexborneol

Authors Title Citation Core tip / conclusive remarks

Chen W, Zhang H, Li Z, Deng Q, Wang M, Chen Y, Zhang Y. Effects of edaravone dexborneol on functional outcome and inflammatory response in patients with acute ischemic stroke. BMC Neurol. 2024 Jun 20; 24(1):209. Treatment with edaravone dexborneol resulted in a favorable functional outcome at 90 days post-stroke onset when compared to patients without this intervention; it also suppressed proinflammatory factors expression while increasing anti-inflammatory factors levels.
Xiao P, Huang H, Zhao H, Liu R, Sun Z, Liu Y, Chen N, Zhang Z. Edaravone dexborneol protects against cerebral ischemia/reperfusion-induced blood-brain barrier damage by inhibiting ferroptosis via activation of nrf-2/HO-1/GPX4 signaling. Free Radic Biol Med. 2024 May 1; 217:116-125. This study revealed for the first time that Eda.B safeguarded the BBB from cerebral I/R injury by inhibiting ferroptosis through the activation of the Nrf-2/HO-1/GPX4 axis, providing a novel insight into the neuroprotective effect of Eda.B in cerebral I/R.
Wang C, Gu HQ, Dong Q, Xu A, Wang N, Yang Y, Wang F, Wang Y. Rationale and design of Treatment of Acute Ischaemic Stroke with Edaravone Dexborneol II (TASTE-2): a multicentre randomized controlled trial. Stroke Vasc Neurol. 2024 Mar 11: svn-2023-002938.  Edaravone, approved to treat amyotrophic lateral sclerosis by the US Food and Drug Administration, has proven to be cytoprotective through early scavenging of free radicals and later exerting anti-inflammatory effects to promote functional recovery and structural integrity in reperfusion animal models.
Wang D, Wang Y, Shi J, Jiang W, Huang W, Chen K, Wang X, Zhang G, Li Y, Cao C, Lee KY, Lin L. Edaravone dexborneol alleviates ischemic injury and neuroinflammation by modulating microglial and astrocyte polarization while inhibiting leukocyte infiltration. Int Immunopharmacol. 2024 Mar 30; 130:111700.  EDB protects against ischemic stroke injury by inhibiting the proinflammatory activation of microglia/macrophages and astrocytes and through reduction by invasion of circulating immune cells, which reduces central and peripheral inflammation following stroke.
Li J, Cao W, Zhao F, Jin P. Cost-effectiveness of edaravone dexborneol versus dl-3-n-butylphthalide for the treatment of acute ischemic stroke: a Chinese health care perspective.  BMC Public Health. 2024 Feb 12; 24(1):436.  Edaravone dexborneol and dl-3-n-butylphthalide are two innovative brain cytoprotective drugs from China that have been approved and widely prescribed for acute ischemic stroke. Edaravone dexborneol is a cost-effective alternative compared with dl-3-n-butylphthalide for acute ischemic stroke patients in current medical setting of China.