ArticleNeurosurgical review2024
Comparison of efficacy between clazosentan and fasudil hydrochloride-based management of vasospasm after subarachnoid hemorrhage focusing on older and WFNS grade V patients: a single-center experience in Japan.
Article in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Clazosentan in aneurysmal subarachnoid hemorrhage: an updated systematic review and meta-analysis of efficacy and safety.BMC neurology · 2026Pooled it
- Clazosentan for cerebral vasospasm prevention in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- The Clinical Factors Associated with Clazosentan Discontinuation and Exploratory Associations with Discharge and Six-Month Outcomes in Aneurysmal Subarachnoid Hemorrhage: A Multicenter DCI Japan Registry Study.Journal of clinical medicine · 2026Article
- Adjunctive Fasudil Use and Outcomes After Clazosentan Treatment for Aneurysmal Subarachnoid Hemorrhage: A Multicenter DCI Japan Registry Study.Journal of clinical medicine · 2026Article
- Practical Guide to Clazosentan Administration in Patients with Aneurysmal Subarachnoid Hemorrhage.Neurologia medico-chirurgica · 2026Article
- Heterogeneity of Clazosentan Benefit after Aneurysmal Subarachnoid Hemorrhage Demonstrated in an Externally Validated Causal Policy Tree.Neurocritical care · 2026Article
- Subarachnoid Hemorrhage: Clazosentan vs. Fasudil for Vasospasm Prevention (SAVIOR) Study: Study Protocol for a Prospective, Multicenter, Randomized Trial.Neurocritical care · 2026Article
- Feasibility and Outcomes of Clazosentan in Ruptured Vertebrobasilar Dissecting Aneurysms: A Retrospective Cohort Study.Health science reports · 2026Article
- Safety and effectiveness of clazosentan in patients after aneurysmal subarachnoid haemorrhage: a second interim report of a post-marketing surveillance in Japan.Neurosurgical review · 2026Article
- Rescue clazosentan for symptomatic cerebral vasospasm following subarachnoid hemorrhage due to anterior cranial fossa dural arteriovenous fistula: A case report with serial angiographic evaluation.Surgical neurology international · 2026Article
- Prognostic factors in aneurysmal subarachnoid hemorrhage during the clazosentan era: a multicenter study using multivariate analyses and machine learning model.Neurosurgical review · 2025Observational
- Quantitative evaluation of the vasodilatory effect of clazosentan in preventing cerebral vasospasm after subarachnoid hemorrhage.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Clinical factors associated with delayed ischemic and non-ischemic adverse events in clazosentan therapy after aneurysmal subarachnoid hemorrhage: early insights from a multicenter prospective registry.Neurosurgical review · 2025Article
- Multicenter Validation of a Unified Evidence-Based Treatment Protocol Focusing on Clazosentan for Managing Subarachnoid Hemorrhage.Journal of clinical medicine · 2025Article
- Spinal Drainage and Combined Pharmacotherapy as Potential Strategies to Improve Outcomes for Patients with Poor-Grade Subarachnoid Hemorrhage Treated with Clipping or Coiling but Not Receiving Nimodipine.Journal of clinical medicine · 2025Article
- Treatment Outcomes of Clazosentan Use During the Perioperative Period for Subarachnoid Hemorrhage.Cureus · 2025Article
- Impact of Clazosentan on Vasospasm Reduction and Functional Recovery after Aneurysmal Subarachnoid Hemorrhage.Neurologia medico-chirurgica · 2025Article
- Symptomatic Vasospasm Refractory to Clazosentan after Subarachnoid Hemorrhage of Ruptured Vertebral Artery Dissecting Aneurysm: Clinical Implications from Two Contrasting Cases.Medicina (Kaunas, Lithuania) · 2024Article
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Subarachnoid hemorrhage often leads to poor outcomes owing to vasospasm, even after successful aneurysm treatment. Clazosentan, an endothelin receptor inhibitor, has been proven to be an effective treatment for vasospasms in a Japanese randomized controlled trial. However, its efficacy in older patients (≥ 75 years old) and those with World Federation of Neurosurgical Societies (WFNS) grade V has not been demonstrated. We retrospectively evaluated the efficacy of clazosentan in older patients and those with WFNS grade V, using real-world data. Patients with subarachnoid hemorrhage treated before and after the introduction of clazosentan were retrospectively evaluated. The patients were categorized into two groups (clazosentan era versus pre-clazosentan era), in which vasospasm management and outcomes were compared. Vasospasms were managed with fasudil hydrochloride-based (pre-clazosentan era) or clazosentan-based treatment (clazosentan era). Seventy-eight patients were included in this study: the clazosentan era (n = 32) and pre-clazosentan era (n = 46). Overall, clazosentan significantly reduced clinical vasospasms (clazosentan era: 31.3% versus pre-clazosentan era: 60.9%, p = 0.01), delayed cerebral ischemia (DCI) (9.4% versus 39.1%, p = 0.004), and vasospasm-related morbidity and mortality (M/M) (3.1% versus 19.6%, p = 0.03). In subgroup analysis of older patients or those with WFNS grade V, no significant difference was observed in clinical outcomes, although both DCI and vasospasm-related M/M were lower in the clazosentan era. Clazosentan was more effective than fasudil-based management in preventing DCI and reducing vasospasm-related M/M. Clazosentan could be used safely in older patients and those with WFNS grade V, although clinical outcomes in these patients were comparable to those of conventional treatment.
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