Quick magnesium treatment fails to improve stroke outcomes, but study has silver lining.
In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.
However, the 8-year trial did find that with the help of paramedics in the field, intravenous medications can frequently be administered to stroke victims within that so-called “golden hour,” during which they have the best chance to survive and avoid debilitating, long-term neurological damage.
The latter finding is a “game-changer,” said Dr. Jeffrey Saver, director of the UCLA Stroke Center and a professor of neurology at the David Geffen School of Medicine at UCLA. Saver served as co-principal investigator on the research, which was presented Feb. 13 at the American Stroke Association’s International Stroke Conference.
“Stroke is a true emergency condition. For every minute that goes by without restoration of blood flow, 2 million nerve cells are lost,” Saver said. “Since time lost is brain lost, we wanted to develop a method that let us get potentially brain-saving drugs to the patient in the earliest moments of onset of the stroke. If these patients don’t get protective drugs until two, three or four hours later, irreversible brain damage has already occurred.”
While the Phase 3 clinical trial found that magnesium does not improve stroke-related disability, the search is now on for new drugs and treatments that can be administered in the field to improve long-term outcomes. The infrastructure to treat patients quickly was created by this study is in place, and that is a major accomplishment, Saver said.
The trial, called Field Administration of Stroke Therapy–Magnesium, or FAST–MAG, involved collaboration among 315 ambulances, 40 emergency medical-service agencies, 60 receiving hospitals and 2,988 paramedics in Los Angeles and Orange counties. Conducted between 2005 and 2013, the study showed that 74 percent of the 1,700 study patients were treated in the first hour, with the magnesium administered within a median time of 45 minutes.