ArticleNeurocritical care2026
Plasma and Cerebrospinal Fluid Pharmacokinetics of Clazosentan and its Relationship to Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage.
Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical pharmacokinetic data on clazosentan, an endothelin receptor antagonist, after aneurysmal subarachnoid hemorrhage (SAH), particularly data on cerebrospinal fluid (CSF), remain limited. In this study, we evaluated the plasma and CSF concentrations and CSF penetration rate of clazosentan over time, and investigated whether the temporal profile differed between patients with SAH with and without delayed cerebral ischemia (DCI).
methodsClinical data, plasma, and CSF samples from 37 patients (mean, 63.2 years) with aneurysmal SAH prospectively collected in the SeCAS registry (nine stroke centers in Mie Prefecture, Japan, 2023-2025) were retrospectively analyzed. All patients underwent aneurysm obliteration within 48 h of SAH onset and were subsequently treated with continuous intravenous clazosentan (10 mg/h), with simultaneous collection of plasma and CSF over time. Clazosentan concentrations in plasma and CSF at post-SAH days 0-3, 4-6, 7-9, and 10-12 were measured by quantitative liquid chromatography-tandem mass spectrometry, and the CSF penetration rate was calculated. Mixed-effect models for repeated measures were used to assess temporal changes and period-by-DCI interactions.
resultsDCI occurred in seven patients (18.9%). In the overall cohort, plasma clazosentan concentrations decreased over time (p = 0.010). CSF concentrations showed no significant temporal change (p = 0.190), whereas the CSF penetration rate increased over time (p < 0.001). The temporal profile of CSF penetration rate differed by DCI status (period-by-DCI interaction, p = 0.008). In pairwise comparisons, the CSF penetration rate at post-SAH days 10-12 was significantly lower in the DCI group (geometric mean ratio 0.3, 95% confidence interval 0.1-0.7, p = 0.008).
conclusionsDuring continuous intravenous infusion of clazosentan after SAH, plasma clazosentan concentrations declined while CSF concentrations were maintained, resulting in an increased CSF penetration rate. Lower CSF penetration was observed at days 10-12 in patients who developed DCI, suggesting a potential association between the relative CSF exposure of clazosentan and DCI.
Indexed as
Identifiers
42230476What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.