NEW APPROACHES REGARDING THE USE OF ACTOVEGIN® IN SUBACUTE/POSTACUTE/SUBCHRONIC TRAUMATIC BRAIN INJURY PATIENTS
GELU ONOSE 1,2*, DOROTEEA TEOIBAȘ-ȘERBAN 1, CRISTINA POPESCU 1,2, IOANA ANDONE 1, ELENA BRUMĂ 1, ANCA MIHĂESCU1 , MONICA HARAS 1,2, ANA MARIA BUMBEA 3,4, AURELIAN ANGHELESCU 1,2, TIBERIU SPIRCU 2, CRISTINEL BADIU 1,2, CRISTINA DAIA 1,2
1.“Bagdasar Arseni” Teaching Emergency Hospital, Bucharest, Romania
2.“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
3.Teaching Neuropsychiatry Hospital, Craiova, Romania
4.University of Medicine and Pharmacy, Craiova, Romania
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Traumatic brain injuries (TBIs) are a major cause, including for significant disabilities, currently with no cure. The neurobiotrophic Actovegin® is considered, yet scarcely studied in TBI. The aim of the study was to comparatively assess the outcomes of Actovegin® therapy on post-TBI patients treated with this medicine versus patients who received standard therapy. The study was conducted on patients who were admitted for the first time to the Rehabilitation Medicine Clinic Division of The “Bagdasar-Arseni” Teaching Emergency Hospital, Bucharest, Romania, between December 2004 - May 2016, with the diagnosis of (post-acute) TBI at their first hospitalization (about 1 month duration), within 4 months since trauma. We reviewed medical records of 74 post TBI inpatients, admitted in our unit. The control group included 41 patients with only standard supportive and neuro-rehabilitative, therapies; the study group (33 patients) received additionally 200 mg Actovegin®, 2 tablets/day. Outcomes were objectified through the following scales: Functional Independence Measure (FIM - total (t), motor (m), cognitive (c)) modified Rankin (Disability) Score (mR(D)S), Glasgow Outcome Score (GOS), Disability Rating Scale (DRS), Activities of Daily Living (ADL), comparatively: at discharge versus admission. The evolution scores showed a mean increase in FIMt, FIMm, FIMc and respectively, DRS values, highly significant, for the Actovegin® group than for the control group (p < 0.001) and, in percentages, significantly higher on GOS (p = 0.001), mR(D)S (p = 0.011) and ADL (p = 0.021). Actovegin® administration appears to improve functional outcomes post TBI, measured on all the standardized scales we used. However, larger patients groups, prophensive including for adequate meta-analyses, are needed.
