Ashish Pemawat: Can We Protect the Brain while We Restore Blood Flow?
Ashish Pemawat, Associate Director of Institute of Neurosciences, Consultant Neurologist at Ethos Hospital Kota, shared on LinkedIn about a recent article by Shuya Li et al., published in JAMA, adding:
“Can we protect the brain while we restore blood flow?
The LAIS Trial offers an intriguing signal.
The recently published LAIS Randomized Clinical Trial in JAMA evaluated loberamisal, a novel neuroprotective agent, in 998 patients with acute ischemic stroke treated within 48 hours of symptom onset.
At 90 days, 69.7% of patients receiving loberamisal achieved an excellent functional outcome (mRS 0–1), compared with 56.3% with placebo—an absolute difference of approximately 13 percentage points. The safety profile was broadly comparable between groups.
What makes LAIS particularly interesting is its therapeutic concept. Modern acute stroke care has focused predominantly on reperfusion—thrombolysis and thrombectomy. Loberamisal represents a different approach: attempting to protect vulnerable neurons from the cascade of ischemic injury through modulation of PSD-95–nNOS and GABA-A pathways.
The results are encouraging, but important questions remain. The trial was conducted in China, involved a selected patient population, and these findings will need confirmation in diverse populations and clinical settings.
If replicated, neuroprotection could potentially complement—not replace—reperfusion therapy.
Perhaps the future of acute ischemic stroke treatment will involve a combination of:
- Recanalize the vessel.
- Protect the tissue.
- Preserve function.
LAIS is an important step in revisiting a therapeutic strategy that has remained largely elusive in stroke medicine.”
Title: Loberamisal for Acute Ischemic Stroke: The LAIS Randomized Clinical Trial
Authors: Shuya Li, Baoyu Feng, Dandan He, Xuechun Wang, Hao Li, Shuhong Xu, Hong-Qiu Gu, Xiaohua Xiao, Dan Deng, Xiaoli Wang, Aihong Guo, Hongguo Dai, Zixiao Li, Yilong Wang, Xingquan Zhao, Liping Liu, Yongjun Wang
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