Abstract Number: Esoc2026lb109 Beyond Anterior Circulation: Clinical Outcomes of Edaravone Dexborneol in Posterior Circulation Stroke

Abstract Background and aims Edaravone dexborneol, a neuroprotective compound with dual antioxidant and anti-inflammatory properties, has been shown to improve recovery in acute ischemic stroke (AIS). Evidence regarding its use in posterior circulation stroke has not been investigated. This study aims to evaluate the clinical effectiveness of edaravone dexborneol in this patient subgroup. Methods We conducted a prospective, multicenter, real-world cohort study in 72 Chinese hospitals from December 2022 to October 2023. Patients were divided into those treated with edaravone dexborneol (37.5 mg twice daily for 14 days) and those not. The primary endpoint was a modified Rankin Scale (mRS) score of ≤2 at 90 days. Secondary outcomes included mRS distribution, changes in National Institutes of Health Stroke Scale (NIHSS) scores, 90 - day quality of life (EuroQol 5 - Dimension 5 - Level EQ - 5D - 5L), and mortality. Analyses were adjusted for baseline covariates, and sensitivity analyses were done using propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Results Among 256 patients (180treated, 76controls), baseline profiles were comparable and remained balanced after matching (62 pairs). At 90 days, the edaravone dexborneol group had a higher functional independence rate (76.1% vs. 64.5%) and a significant shift to better mRS outcomes (adjusted common OR, 1.69; 95%CI, 1.03-2.78; P=0.04). There was also greater NIHSS improvement (adjusted β=-1.95; P=0.03), but mortality and EQ-5D-5L scores were similar between groups. Conclusions Treatment with edaravone dexborneol was associated with improved functional outcomes and neurological recovery in posterior circulation stroke. These findings warrant confirmation in large randomized controlled trials. Conflict of interest