Cardiac arrest & resuscitation
Nelonemdaz Treatment for Patients With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial
Authors' conclusion
Nelonemdaz treatment of patients after OHCA did not reduce serum NSE levels compared with controls. Patients treated with high-dose nelonemdaz showed higher brain MRI fractional anisotropy suggesting less cerebral white matter damage.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients undergoing TTM, 5 sites in South Korea, 2018–202393 evaluated for primary outcome
- Participants
- 105 patients
- Comparison
- Nelonemdaz high-dose or low-dose vs placebo
- High-dosen = 37
- Low-dosen = 35
- Placebon = 33reference
- Primary endpoint
- Serum neuron-specific enolase (NSE) level
- Follow-up
- 48-52 hours
Methodological detailsdouble-blind, placebo-controlled, multicentre, phase II
- Double-blind
- Placebo-controlled
- Multicentre
- Phase II
Primary result
As reported in the abstract
Serum NSE
High-dose
23.7
median · IQR 15.0–69.9
Low-dose
26.6
median · IQR 16.2–83.4
Placebo
17.5
median · IQR 13.6–113.0
- No difference in serum neuron-specific enolase (NSE) between high-dose and placebo, or between low-dose and placebo
- P > 0.05
Further findings
| Outcome | Common OR (95% CI) | P value | |
|---|---|---|---|
| Favorable shift in modified Rankin Scale · day 90High-dose vs Placebo | 1.25 (0.48–3.24) | P > 0.05 | |
| Favorable shift in modified Rankin Scale · day 90Low-dose vs Placebo | 1.22 (0.47–3.20) | P > 0.05 | |
| 0.20.5125Common OR (log scale) |
| Outcome | High-dose | Low-dose | Placebo | P value |
|---|---|---|---|---|
| Brain MRI fractional anisotropyHigh-dose vs Placebo · significantly higher in high-dose | 0.465 (IQR 0.449–0.485) | 0.462 (IQR 0.439–0.480) | 0.441 (IQR 0.431–0.464) | P = 0.028 |
| Brain MRI fractional anisotropyLow-dose vs Placebo | P > 0.05 |
Safety
- No serious adverse events reported
Original publication
Nelonemdaz Treatment for Patients With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. Crit Care Med. Published 14 January 2025. doi:10.
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