Edaravone Dexborneol Improves Functional Outcomes After Acute Ischaemic Stroke: Study
China: Researchers have found in a new study that Edaravone dexborneol significantly improved functional independence at 90 days compared with placebo in patients with acute ischaemic stroke who underwent endovascular thrombectomy. It is a novel multitarget brain cytoprotective agent with proven efficacy, including in the treatment of patients not receiving reperfusion therapy.
The findings come from the TASTE-2 trial, a multicentre, double-blind, randomised study published in The BMJ and led by Chunjuan Wang, Associate Professor of Neurology at Beijing Tiantan Hospital, China. The trial evaluated whether adding edaravone dexborneol to standard care could improve recovery in patients undergoing endovascular thrombectomy for large vessel occlusion stroke.
Edaravone dexborneol, a combination of antioxidant and anti-inflammatory agents, protects brain tissue from secondary injury after ischaemia and reperfusion. While its benefits are established in patients not receiving reperfusion therapy, evidence in thrombectomy settings has been limited.
From March 2022 to May 2023, 1362 adults aged 18–80 years with acute anterior circulation stroke within 24 hours of onset, moderate to severe neurological deficits, and planned thrombectomy were enrolled from 106 hospitals across China. Participants were randomly assigned 1:1 to edaravone dexborneol or placebo.
The intervention group received 37.5 mg twice daily, starting before thrombectomy and continuing for 10–14 days; the control group received a matching placebo. The primary outcome was functional independence at 90 days (modified Rankin Scale 0–2), and safety was assessed via serious adverse events.
The trial revealed the following findings:
- Among 1360 patients analyzed, 55.0% of those treated with edaravone dexborneol achieved functional independence at 90 days, compared with 49.6% in the placebo group.
- The absolute risk difference between the edaravone dexborneol and placebo groups was 5.4%, reaching borderline statistical significance.
- Subgroup analysis showed that patients with a mismatch profile at admission were more likely to achieve functional independence, with notably higher rates compared with placebo.
- Safety outcomes were similar between the two groups, with no increase in serious adverse events observed in the edaravone dexborneol group.
- These results indicate that edaravone dexborneol was well-tolerated when administered alongside endovascular thrombectomy.
The authors acknowledged several limitations, including a smaller-than-anticipated treatment effect, potential selection bias, and limited generalisability due to the inclusion of only anterior circulation strokes and Chinese patients treated at high-volume centres. Despite these constraints, the findings suggest that edaravone dexborneol may provide added functional benefit in selected patients undergoing thrombectomy.
The researchers conclude that edaravone dexborneol was well tolerated and associated with improved functional outcomes at 90 days, particularly among patients with favourable mismatch profiles. They emphasise the need for further dedicated randomised trials to confirm these results and determine the populations most likely to benefit.
Reference: BMJ 2026;392:e086850
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