Newswise — NEW HAVEN, Conn., July 3, 2025 – The diabetes drug glyburide, when administered intravenously, may improve outcomes in some patients with large-core strokes, a new study reveals.
In an article published in Annals of Neurology July 3, an international team led by researchers from Yale School of Medicine and Massachusetts General Hospital compared health outcomes between patients with a type of acute ischemic stroke called large hemispheric infarction (LHI) treated with intravenous glyburide and those treated with a placebo. Patients enrolled in the study had baseline stroke volumes less than 125 mL.
“Current treatments for acute stroke focus on the restoration of blood flow, either through intravenous thrombolysis, endovascular thrombectomy (EVT), or both,” said Kevin Sheth, MD, Professor of Neurology and of Neurosurgery, co-lead investigator and senior author of the study. “We set out to see whether combining these approaches with drugs that target brain swelling could help improve outcomes for patients with lower stroke volumes at a cut point that has been broadly suggested in the field as a potential ceiling for EVT.”
The team found patients in the IV glyburide group were more than twice as likely as those treated with placebo to show improved (lower) scores on the modified Rankin Scale after 90 days, indicating more independence in movement and lifestyle.
For patients undergoing EVT, the researchers found starker differences. These patients showed eight times the likelihood of a good outcome vis a vis the Rankin Scale, less brain swelling and lower overall mortality than those treated with placebo. No patients in the glyburide group needed decompressive surgery after EVT, compared to 25% of patients in the placebo group.
This analysis follows publication of the primary trial results in the Lancet Neurology last fall. The results suggest glyburide could improve outcomes, especially for those patients with a lower stroke volume and those who require EVT. “These combinatory therapies could greatly improve movement and independence outcomes for patients after a stroke,” Sheth said. “Definitive clinical trials are crucial to help confirm these findings.”
W. Taylor Kimberly, MD, PhD, chief of Neurocritical Care at Massachusetts General Hospital, was the study’s co-lead investigator.
