Evidence map›Paper›PMID 40418029›Full record

Trial reportInternational journal of stroke : official journal of the International Stroke Society2025

Early neurological improvement with deferoxamine after intracerebral hemorrhage: A post hoc analysis of the i-DEF trial.

Alexandros A Polymeris, Vasileios-Arsenios Lioutas, Lydia D Foster, Diego Incontri, Elizabeth C Heistand, Juliette Marchal, Alexa Lazar, Urs Fischer, Stefan T Engelter, David J Seiffge and 2 more

Registry-linked trialAbstract readClinical Trial, Phase IIRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of stroke : official journal of the International Stroke Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02175225 (Study of Deferoxamine Mesylate in Intracerebral Hemorrhage), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02175225 phase2completednot on this map

Study of Deferoxamine Mesylate in Intracerebral Hemorrhage

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2014 to 2018Enrolled294ConditionsIntracerebral HemorrhageArmsDeferoxamine Mesylate, Placebo (for Deferoxamine Mesylate)
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Ironing out mechanisms of ferroptotic death to tailor new stroke therapies.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Alexandros A PolymerisStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-9475-2208
Vasileios-Arsenios LioutasStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Lydia D FosterDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.ORCID 0000-0001-6856-5583
Diego IncontriStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Elizabeth C HeistandStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Juliette MarchalStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Alexa LazarStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Urs FischerDepartment of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0003-0521-4051
Stefan T EngelterDepartment of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.ORCID 0000-0003-3855-6234
David J SeiffgeDepartment of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.ORCID 0000-0003-3890-3849
Sharon D YeattsDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Magdy H SelimStroke Division, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Funding

StATins Use in intRacerebral hemorrhage patieNts (SATURN)U01NS102289 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Magdy H Selim · 2019 to 2026
$15.7M
Futility Study of Deferoxamine Mesylate in Intracerebral Hemorrhage (i-DEF)U01NS074425 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SELIM, MAGDY H · 2012 to 2016
$8.7M
Chronic Subdural Hematoma Treatment with Embolization vs Surgery or MedicalManagement Study (CHESS)UG3NS128397 · NINDS · UNIVERSITY OF TEXAS MED BR GALVESTON · PI CASSARLY, CHRISTY, KAN, PETER TZE MAN · 2023 to 2023
$3.5M
StAtins Use in intRacereberal hemorrhage patieNts MRI (SATURN MRI) Ancillary StudyUF1NS120871 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SELIM, MAGDY H, SHOAMANESH, ASHKAN · 2021 to 2021
$2.7M
Safety and Tolerability of Deferoxamine in Acute Cerebral HemorrhageR01NS057127 · NINDS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SELIM, MAGDY H · 2008 to 2010
$1.0M
NINDS NIH HHS R01 NS057127NINDS NIH HHS U01 NS074425NINDS NIH HHS U01 NS102289NINDS NIH HHS UF1 NS120871NINDS NIH HHS UG3 NS128397
6 · The paper itself

Abstract

backgroundLittle is known about early major neurological improvement (EMNI) after intracerebral hemorrhage (ICH).

aimsWe performed a post hoc analysis of the Intracerebral Hemorrhage-Deferoxamine trial (i-DEF; NCT02175225) to comprehensively evaluate EMNI and assess whether deferoxamine treatment affects it.

methodsComparing repeated assessments of National Institutes of Health Stroke Scale (NIHSS) on days 2, 3, 4, and 7 (or discharge, if it was earlier) versus NIHSS score at presentation, and defining EMNI as an NIHSS score decrement of an absolute ⩾4 points from presentation, we determined its presence or absence on day 2, day 3, day 4, and day 7(/discharge). Using adjusted generalized linear mixed-effects or logistic models as appropriate, we examined the association of deferoxamine with EMNI as repeated measure, as well as EMNI's overall frequency, time course, determinants, and association with favorable long-term outcome (modified Rankin Scale 0-2).

resultsAmong 291 i-DEF participants in the modified intention-to-treat population (median age 61 years, 38.5% female, median NIHSS score 13, 144 randomized to deferoxamine and 147 to placebo), the proportion of participants with EMNI continuously increased from 20% on day 2 to 36% on day 7(/discharge). Deferoxamine was associated with an average twofold higher odds of EMNI (odds ratio (OR): 2.30, 95% confidence interval (CI): 1.07 to 4.95, p = 0.033 after adjustment for the prespecified trial covariates onset-to-treatment time, baseline ICH volume, and presenting NIHSS score), without clear evidence for treatment-by-time interaction (p

conclusionIn a post hoc analysis of the i-DEF trial, the likelihood of EMNI over the first week following ICH was higher with deferoxamine. EMNI showed a continuous upward trajectory and strong association with favorable long-term functional outcome.

Indexed as

Cerebral HemorrhageDeferoxamineSiderophoresAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedSeverity of Illness IndexTreatment OutcomeDeferoxamineSiderophoresdeferoxamineearly improvementIntracerebral hemorrhagetrial

Identifiers

PMID40418029
PMCPMC12664922

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Registered trials

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