The Clinical Development of Cerebrolysin: New Approaches in Stroke Studies. a Commentary to the Cars Study

Additional efficacious treatment options for stroke are urgently needed as thrombolysis and endovascular thrombectomy are too rarely utilised due to the narrow time window. This article reviews the clinical profile of Cerebrolysin® (EVER Pharma, Austria), a well-documented compound indicated for the treatment of acute stroke, which has also shown promising results in neurorecovery. Well-conducted clinical trials have shown strong and encouraging treatment signals, either as a single therapy or in combination with recombinant tissue plasminogen activator. This review focusses on the latest research results, especially on the randomised, controlled CARS study, which combined pharmacological and rehabilitation therapy. Furthermore, this study reached the primary endpoint at Day 90 in the Action Research Arm Test and showed significant improvements in modified Rankin Scale (mRS) at Day 90. The same applies to important secondary endpoints such as the National Institutes of Health Stroke Scale (NIHSS) at Day 21 (early benefit). CARS is a rehabilitation study with a larger sample size and gives neurologists as well as rehabilitation specialists renewed confidence in this class of neuroprotective/ neurorecovery-enhancing compounds. Furthermore, ongoing research projects like CREGS-S are discussed, a large-scale prospective registry that adds valuable real-world data to the existing portfolio of Cerebrolysin studies.