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ArticleNeurology and therapy2025

CILO-CLOP Trial: Cilostazol Versus Clopidogrel in Acute Moderate and Moderate-to-Severe Ischemic Stroke: A Randomized Controlled Multicenter Trial.

Mohamed G Zeinhom, Mohamed Ismaiel, Mohamed Fouad Elsayed Khalil, Mohamed Ahmed Almoataz, Tarek Youssif Omar, Ahmed Mohamed Ali Daabis, Hossam Mohamed Refat, Ahmed Ahmed Mohamed Kamal Ebied, Noha Abdelwahed, Ahmed Zaki Omar Akl and 3 more

Registry-linked trialAbstract read
In one paragraph

Article in Neurology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06242132 (Clopidogrel Versus Cilostazol in Ischemic Stroke, a Randomized Controlled Trial), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT06242132 phase3completednot on this map

Clopidogrel Versus Cilostazol in Ischemic Stroke, a Randomized Controlled Trial

TypeinterventionalSponsorKafrelsheikh UniversityRan2022 to 2024Enrolled870ConditionsIschemic StrokeArmsClopidogrel tablet, Cilostazol 100 MG
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
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

13 authors.

Mohamed G ZeinhomNeurology Department, Faculty of Medicine, Kafr El-Sheikh University, Elgeish Street, Kafr El-Sheikh, Egypt. mohamed_gomaa@med.kfs.edu.eg.ORCID http://orcid.org/0000-0002-0337-349X
Mohamed IsmaielNeurology Department, Al-Sahel Teaching Hospital, Cairo, Egypt.
Mohamed Fouad Elsayed KhalilNeurology Department, NMC Royal Hospital, Abu Dhabi, United Arab Emirates.
Mohamed Ahmed AlmoatazNeurology Department, Saudi German Hospital, Sharjah, United Arab Emirates.
Tarek Youssif OmarNeurology Department, Burjeel Medical Centers, Abu Dhabi, United Arab Emirates.
Ahmed Mohamed Ali DaabisNeurology Department, Burjeel Royal Hospital, Al Ain, United Arab Emirates.
Hossam Mohamed RefatNeurology Department, Faculty of Medicine Zagazig University, Zagazig, Egypt.
Ahmed Ahmed Mohamed Kamal EbiedNeurology Department, Faculty of Medicine Zagazig University, Zagazig, Egypt.
Noha AbdelwahedNeurology Department, Emirates Hospital Group, Dubai, UAE.
Ahmed Zaki Omar AklNeurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Emad Labib Abdelhamid MahmoudCardiology Department, National Heart Institute, Cairo, Egypt.
Salah Ibrahim AhmedNeurology Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Sherihan Rezk AhmedNeurology Department, Faculty of Medicine, Kafr El-Sheikh University, Elgeish Street, Kafr El-Sheikh, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAll large studies evaluating the role of cilostazol versus other antiplatelet agents in stroke prevention have been conducted in Asia and included patients with minor stroke or transient ischemic attack (TIA). Ours is the first-ever trial to evaluate the safety and efficacy of cilostazol versus clopidogrel in moderate and moderate-to-severe ischemic stroke in North Africa. Accordingly, in this study we assess the role of cilostazol as an alternative to clopidogrel in Egyptian patients with first-ever non-cardioembolic moderate or moderate-to-severe ischemic stroke.

methodsA total of 870 patients with moderate and moderate-to-severe acute ischemic stroke (AIS) were randomly assigned to administration of loading and maintenance doses of cilostazol or clopidogrel.

resultsOf the 870 patients included in our trial, 37 (8.7%) in the cilostazol arm and 59 (13.6%) in the clopidogrel arm experienced a new stroke (HR 0.53; 95% CI, 0.33-0.84; P = 0.007). Twelve participants (2.8%) in the cilostazol group and 25 patients (5.7%) in the clopidogrel group experienced drug-related hemorrhagic complications (HR 0.25; 95% CI, 0.12-0.53; P = 0.001). Patients with hypertension who received cilostazol had significantly lower rates of recurrent hemorrhagic and ischemic stroke.

conclusionEgyptian patients with non-cardioembolic moderate and moderate-to-severe ischemic stroke who received cilostazol within the first 24 h of symptoms had significantly lower rates of hemorrhagic transformation of brain infarction and peripheral hemorrhagic complications than those who received clopidogrel. Patients with hypertension achieved the greatest benefit from cilostazol, as they experienced a significant reduction in recurrent ischemic and hemorrhagic infarction. There were no significant differences between the two groups regarding the modified Rankin scale (mRS) score after 3 months or in the non-hemorrhagic side effects. Our results were derived from a single-blinded study; a more extensive, double-blinded, multinational study is needed for the results to be generalizable worldwide.

trial registrationRetrospectively registered, ClinicalTrials.gov, NCT06242132, 27-01-2024.

Indexed as

CilostazolClopidogrelEgyptModerate ischemic strokeModerate-to-severe stroke

Identifiers

PMID40220202
PMCPMC12089640

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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 Socratic graph.