Dapsone Use in Patients With Aneurysmal Subarachnoid Hemorrhage.

Summary

Dapsone is a drug that has been used clinically for several decades due to its anti-infective effect, making it widely available. Its neuroprotective effects have been found through its glutamate receptors antagonistic effect. Their main objective was to study the neuroprotective properties in patients with aneurysmal subarachnoid hemorrhage and high-risk factors for the development of cerebral vasospasm. Both the placebo and the dapsone used in this clinical trial were provided by the institution's neurochemistry laboratory.

Timeline

Start

2007-09-05

Primary completion

2008-12-07

Completion

2009-03-10

Publications

• Background Goddard AJ, Raju PP, Gholkar A. Does the method of treatment of acutely ruptured intracranial aneurysms influence the incidence and duration of cerebral vasospasm and clinical outcome? J Neurol Neurosurg Psychiatry. 2004 Jun;75(6):868-72. doi: 10.1136/jnnp.2003.033068.
• Background Ahn SH, Savarraj JP, Pervez M, Jones W, Park J, Jeon SB, Kwon SU, Chang TR, Lee K, Kim DH, Day AL, Choi HA. The Subarachnoid Hemorrhage Early Brain Edema Score Predicts Delayed Cerebral Ischemia and Clinical Outcomes. Neurosurgery. 2018 Jul 1;83(1):137-145. doi: 10.1093/neuros/nyx364.
• Background Asano T, Takakura K, Sano K, Kikuchi H, Nagai H, Saito I, Tamura A, Ochiai C, Sasaki T. Effects of a hydroxyl radical scavenger on delayed ischemic neurological deficits following aneurysmal subarachnoid hemorrhage: results of a multicenter, placebo-controlled double-blind trial. J Neurosurg. 1996 May;84(5):792-803. doi: 10.3171/jns.1996.84.5.0792.
• Background Bothun ML, Haaland OA, Moen G, Logallo N, Svendsen F, Thomassen L, Helland CA. Impaired cerebrovascular reactivity may predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurol Sci. 2019 Dec 15;407:116539. doi: 10.1016/j.jns.2019.116539. Epub 2019 Oct 17.
• Background Boulouis G, Labeyrie MA, Raymond J, Rodriguez-Regent C, Lukaszewicz AC, Bresson D, Ben Hassen W, Trystram D, Meder JF, Oppenheim C, Naggara O. Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage: a systematic review and meta-analysis. Eur Radiol. 2017 Aug;27(8):3333-3342. doi: 10.1007/s00330-016-4702-y. Epub 2016 Dec 21.
• Background Chen J, Li M, Zhu X, Chen L, Yang S, Zhang C, Wu T, Feng X, Wang Y, Chen Q. Atorvastatin reduces cerebral vasospasm and infarction after aneurysmal subarachnoid hemorrhage in elderly Chinese adults. Aging (Albany NY). 2020 Feb 7;12(3):2939-2951. doi: 10.18632/aging.102788. Epub 2020 Feb 7.
• Background Chugh C, Agarwal H. Cerebral vasospasm and delayed cerebral ischemia: Review of literature and the management approach. Neurol India. 2019 Jan-Feb;67(1):185-200. doi: 10.4103/0028-3886.253627.
• Background Claassen J, Bernardini GL, Kreiter K, Bates J, Du YE, Copeland D, Connolly ES, Mayer SA. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke. 2001 Sep;32(9):2012-20. doi: 10.1161/hs0901.095677.
• Background Dasenbrock HH, Rudy RF, Rosalind Lai PM, Smith TR, Frerichs KU, Gormley WB, Aziz-Sultan MA, Du R. Cigarette smoking and outcomes after aneurysmal subarachnoid hemorrhage: a nationwide analysis. J Neurosurg. 2018 Aug;129(2):446-457. doi: 10.3171/2016.10.JNS16748. Epub 2017 Oct 27.
• Background Ditz C, Leppert J, Neumann A, Krajewski KL, Gliemroth J, Tronnier VM, Kuchler J. Cerebral Vasospasm After Spontaneous Subarachnoid Hemorrhage: Angiographic Pattern and Its Impact on the Clinical Course. World Neurosurg. 2020 Jun;138:e913-e921. doi: 10.1016/j.wneu.2020.03.146. Epub 2020 Apr 2.
• Background Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery. 1980 Jan;6(1):1-9. doi: 10.1227/00006123-198001000-00001.
• Background Gatti G, Hossein J, Malena M, Cruciani M, Bassetti M. Penetration of dapsone into cerebrospinal fluid of patients with AIDS. J Antimicrob Chemother. 1997 Jul;40(1):113-5. doi: 10.1093/jac/40.1.113.
• Background Haley EC Jr, Kassell NF, Apperson-Hansen C, Maile MH, Alves WM. A randomized, double-blind, vehicle-controlled trial of tirilazad mesylate in patients with aneurysmal subarachnoid hemorrhage: a cooperative study in North America. J Neurosurg. 1997 Mar;86(3):467-74. doi: 10.3171/jns.1997.86.3.0467.
• Background He J, Zhang X, He W, Xie Y, Chen Y, Yang Y, Chen R. Neuroprotective effects of zonisamide on cerebral ischemia injury via inhibition of neuronal apoptosis. Braz J Med Biol Res. 2021 Feb 26;54(4):e10498. doi: 10.1590/1414-431X202010498. eCollection 2021.
• Background Hoh BL, Topcuoglu MA, Singhal AB, Pryor JC, Rabinov JD, Rordorf GA, Carter BS, Ogilvy CS. Effect of clipping, craniotomy, or intravascular coiling on cerebral vasospasm and patient outcome after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2004 Oct;55(4):779-86; discussion 786-9. doi: 10.1227/01.neu.0000137628.51839.d5.
• Background Hollingworth M, Jamjoom AAB, Bulters D, Patel HC. How is vasospasm screening using transcranial Doppler associated with delayed cerebral ischemia and outcomes in aneurysmal subarachnoid hemorrhage? Acta Neurochir (Wien). 2019 Feb;161(2):385-392. doi: 10.1007/s00701-018-3765-8. Epub 2019 Jan 12.
• Background Hosoda K, Fujita S, Kawaguchi T, Shose Y, Hamano S, Iwakura M. Effect of clot removal and surgical manipulation on regional cerebral blood flow and delayed vasospasm in early aneurysm surgery for subarachnoid hemorrhage. Surg Neurol. 1999 Jan;51(1):81-8. doi: 10.1016/s0090-3019(97)00508-9.
• Background Ido K, Kurogi R, Kurogi A, Nishimura K, Arimura K, Nishimura A, Ren N, Kada A, Matsuo R, Onozuka D, Hagihara A, Takagishi S, Yamagami K, Takegami M, Nohara Y, Nakashima N, Kamouchi M, Date I, Kitazono T, Iihara K; J-ASPECT Study Collaborators. Effect of treatment modality and cerebral vasospasm agent on patient outcomes after aneurysmal subarachnoid hemorrhage in the elderly aged 75 years and older. PLoS One. 2020 Apr 9;15(4):e0230953. doi: 10.1371/journal.pone.0230953. eCollection 2020.
• Background Inagawa T, Yahara K, Ohbayashi N. Risk factors associated with cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Neurol Med Chir (Tokyo). 2014 Jun 17;54(6):465-73. doi: 10.2176/nmc.oa.2013-0169. Epub 2014 Mar 27.
• Background Pickard JD, Murray GD, Illingworth R, Shaw MD, Teasdale GM, Foy PM, Humphrey PR, Lang DA, Nelson R, Richards P, et al. Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial. BMJ. 1989 Mar 11;298(6674):636-42. doi: 10.1136/bmj.298.6674.636.
• Background Keller E, Krayenbuhl N, Bjeljac M, Yonekawa Y. Cerebral vasospasm: results of a structured multimodal treatment. Acta Neurochir Suppl. 2005;94:65-73. doi: 10.1007/3-211-27911-3_11.
• Background Laumer R, Steinmeier R, Gonner F, Vogtmann T, Priem R, Fahlbusch R. Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial Doppler sonography. Part 1. Reliability of flow velocities in clinical management. Neurosurgery. 1993 Jul;33(1):1-8; discussion 8-9. doi: 10.1227/00006123-199307000-00001.
• Background Lewis DH, Newell DW, Winn HR. Delayed ischemia due to cerebral vasospasm occult to transcranial Doppler. An important role for cerebral perfusion SPECT. Clin Nucl Med. 1997 Apr;22(4):238-40. doi: 10.1097/00003072-199704000-00006.
• Background Li K, Barras CD, Chandra RV, Kok HK, Maingard JT, Carter NS, Russell JH, Lai L, Brooks M, Asadi H. A Review of the Management of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage. World Neurosurg. 2019 Jun;126:513-527. doi: 10.1016/j.wneu.2019.03.083. Epub 2019 Mar 18.
• Background Lopez-Naranjo F, Castaneda-Lopez C, Rojas-Oviedo I, Altagracia-Martinez M, Krazov-Jinich J, Manjarrez-Marmolejo J, Alvarado-Calvillo R. Anticonvulsant activity of dapsone analogs. Electrophysiologic evaluation. Arch Med Res. 2003 Jul-Aug;34(4):269-72. doi: 10.1016/S0188-4409(03)00045-6.
• Background Matsuda N, Naraoka M, Ohkuma H, Shimamura N, Ito K, Asano K, Hasegawa S, Takemura A. Effect of Cilostazol on Cerebral Vasospasm and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage: A Randomized, Double-Blind, Placebo-Controlled Trial. Cerebrovasc Dis. 2016;42(1-2):97-105. doi: 10.1159/000445509. Epub 2016 Apr 13.
• Background McGirt MJ, Mavropoulos JC, McGirt LY, Alexander MJ, Friedman AH, Laskowitz DT, Lynch JR. Leukocytosis as an independent risk factor for cerebral vasospasm following aneurysmal subarachnoid hemorrhage. J Neurosurg. 2003 Jun;98(6):1222-6. doi: 10.3171/jns.2003.98.6.1222.
• Background Mee E, Dorrance D, Lowe D, Neil-Dwyer G. Controlled study of nimodipine in aneurysm patients treated early after subarachnoid hemorrhage. Neurosurgery. 1988 Mar;22(3):484-91. doi: 10.1227/00006123-198803000-00006.
• Background Ohman J, Heiskanen O. Effect of nimodipine on the outcome of patients after aneurysmal subarachnoid hemorrhage and surgery. J Neurosurg. 1988 Nov;69(5):683-6. doi: 10.3171/jns.1988.69.5.0683.
• Background Parra A, Kreiter KT, Williams S, Sciacca R, Mack WJ, Naidech AM, Commichau CS, Fitzsimmons BF, Janjua N, Mayer SA, Connolly ES Jr. Effect of prior statin use on functional outcome and delayed vasospasm after acute aneurysmal subarachnoid hemorrhage: a matched controlled cohort study. Neurosurgery. 2005 Mar;56(3):476-84; discussion 476-84. doi: 10.1227/01.neu.0000153925.96889.8a.
• Background Patel AP, Patil AS. Dapsone for immune thrombocytopenic purpura in children and adults. Platelets. 2015;26(2):164-7. doi: 10.3109/09537104.2014.886677. Epub 2014 Feb 10.
• Background Petruk KC, West M, Mohr G, Weir BK, Benoit BG, Gentili F, Disney LB, Khan MI, Grace M, Holness RO, et al. Nimodipine treatment in poor-grade aneurysm patients. Results of a multicenter double-blind placebo-controlled trial. J Neurosurg. 1988 Apr;68(4):505-17. doi: 10.3171/jns.1988.68.4.0505.
• Background Porro AM, Hans Filho G, Santi CG. Consensus on the treatment of autoimmune bullous dermatoses: pemphigus vulgaris and pemphigus foliaceus - Brazilian Society of Dermatology. An Bras Dermatol. 2019 Apr;94(2 Suppl 1):20-32. doi: 10.1590/abd1806-4841.2019940206. Epub 2019 Jun 3.
• Background Qureshi AI, Sung GY, Razumovsky AY, Lane K, Straw RN, Ulatowski JA. Early identification of patients at risk for symptomatic vasospasm after aneurysmal subarachnoid hemorrhage. Crit Care Med. 2000 Apr;28(4):984-90. doi: 10.1097/00003246-200004000-00012.
• Background Rabinstein AA, Friedman JA, Weigand SD, McClelland RL, Fulgham JR, Manno EM, Atkinson JL, Wijdicks EF. Predictors of cerebral infarction in aneurysmal subarachnoid hemorrhage. Stroke. 2004 Aug;35(8):1862-6. doi: 10.1161/01.STR.0000133132.76983.8e. Epub 2004 Jun 24.
• Background Reilly C, Amidei C, Tolentino J, Jahromi BS, Macdonald RL. Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2004 Aug;101(2):255-61. doi: 10.3171/jns.2004.101.2.0255.
• Background Rios C, Nader-Kawachi J, Rodriguez-Payan AJ, Nava-Ruiz C. Neuroprotective effect of dapsone in an occlusive model of focal ischemia in rats. Brain Res. 2004 Mar 5;999(2):212-5. doi: 10.1016/j.brainres.2003.11.040.
• Background Roman C, Dima B, Muyshont L, Schurmans T, Gilliaux O. Indications and efficiency of dapsone in IgA vasculitis (Henoch-Schonlein purpura): case series and a review of the literature. Eur J Pediatr. 2019 Aug;178(8):1275-1281. doi: 10.1007/s00431-019-03409-5. Epub 2019 Jun 22.
• Background Shimoda M, Takeuchi M, Tominaga J, Oda S, Kumasaka A, Tsugane R. Asymptomatic versus symptomatic infarcts from vasospasm in patients with subarachnoid hemorrhage: serial magnetic resonance imaging. Neurosurgery. 2001 Dec;49(6):1341-8; discussion 1348-50. doi: 10.1097/00006123-200112000-00010.
• Background Suda T, Suzuki Y, Matsui T, Inoue T, Niide O, Yoshimaru T, Suzuki H, Ra C, Ochiai T. Dapsone suppresses human neutrophil superoxide production and elastase release in a calcium-dependent manner. Br J Dermatol. 2005 May;152(5):887-95. doi: 10.1111/j.1365-2133.2005.06559.x.
• Background Tatu L, Moulin T, Bogousslavsky J, Duvernoy H. Arterial territories of the human brain: cerebral hemispheres. Neurology. 1998 Jun;50(6):1699-708. doi: 10.1212/wnl.50.6.1699.
• Background Teasdale GM, Drake CG, Hunt W, Kassell N, Sano K, Pertuiset B, De Villiers JC. A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry. 1988 Nov;51(11):1457. doi: 10.1136/jnnp.51.11.1457. No abstract available.
• Background Thomas JE, Rosenwasser RH, Armonda RA, Harrop J, Mitchell W, Galaria I. Safety of intrathecal sodium nitroprusside for the treatment and prevention of refractory cerebral vasospasm and ischemia in humans. Stroke. 1999 Jul;30(7):1409-16. doi: 10.1161/01.str.30.7.1409.
• Background Tseng MY, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage: a phase II randomized placebo-controlled trial. Stroke. 2005 Aug;36(8):1627-32. doi: 10.1161/01.STR.0000176743.67564.5d.
• Background Van Malderen C, Van Geertruyden JP, Machevo S, Gonzalez R, Bassat Q, Talisuna A, Yeka A, Nabasumba C, Piola P, Daniel A, Turyakira E, Forret P, Van Overmeir C, van Loen H, Robert A, D' Alessandro U. Glucose-6-phosphate dehydrogenase deficiency, chlorproguanil-dapsone with artesunate and post-treatment haemolysis in African children treated for uncomplicated malaria. Malar J. 2012 Jul 10;11:139. doi: 10.1186/1475-2875-11-139.
• Background Zhao J, Zhou D, Guo J, Ren Z, Zhou L, Wang S, Zhang Y, Xu B, Zhao K, Wang R, Mao Y, Xu B, Zhang X; Fasudil Aneurysmal Subarachnoid Hemorrhage Study Group. Efficacy and safety of fasudil in patients with subarachnoid hemorrhage: final results of a randomized trial of fasudil versus nimodipine. Neurol Med Chir (Tokyo). 2011;51(10):679-83. doi: 10.2176/nmc.51.679.

Drugs

Indications