TASTE-2
(2026)Objective
To assess the efficacy and safety of edaravone dexborneol in improving functional outcomes among patients with acute ischaemic stroke undergoing endovascular thrombectomy.
Study Summary
• 1362 patients with acute ischaemic stroke within 24 hours of symptom onset with large vessel occlusion in anterior circulation undergoing endovascular thrombectomy
• Patients received edaravone dexborneol 37.5 mg or placebo twice daily for 10-14 days, with first dose administered before thrombectomy
Intervention
Edaravone dexborneol 37.5 mg (edaravone 30 mg + dexborneol 7.5 mg) intravenously twice daily for 10-14 consecutive days versus placebo
Inclusion Criteria
Age 18-80 years, acute ischaemic stroke within 24 hours, NIHSS score 6-25, ASPECTS 6-10, anterior large vessel occlusion (ICA, T-bifurcation, or M1), planned endovascular thrombectomy
Study Design
Arms: Edaravone dexborneol 37.5 mg twice daily vs Placebo
Patients per Arm: 690 in edaravone dexborneol group, 672 in placebo group
Outcome
• Subgroup with mismatch at admission showed greater benefit: 55.5% vs 42.9% (RR 1.29, 95% CI 1.10-1.52; P for interaction=0.003)
• Similar rates of serious adverse events: 27.2% vs 25.7% (P=0.53)
Bottom Line
Among patients with acute ischaemic stroke within 24 hours undergoing endovascular thrombectomy, edaravone dexborneol was marginally superior to placebo in achieving functional independence at 90 days (55.0% vs 49.6%, P=0.05), with significant benefit observed in the subgroup with mismatch present at admission, without increased safety concerns.
Major Points
- Edaravone dexborneol showed marginal superiority over placebo for functional independence at 90 days (55.0% vs 49.6%; RR 1.11, 95% CI 1.00-1.23; P=0.05)
- Subgroup analysis revealed substantial benefit in patients with mismatch at admission (55.5% vs 42.9%; RR 1.29, 95% CI 1.10-1.52; P for interaction=0.003)
- Safety profile was comparable between groups with similar rates of serious adverse events (27.2% vs 25.7%)
- First dose was administered before endovascular thrombectomy, followed by twice-daily dosing for 10-14 days
- The study supports the potential role of cytoprotective agents in combination with reperfusion therapy
Study Design
- Study Type
- Randomised controlled trial
- Randomization
- Yes
- Blinding
- Double-blind (participants, investigators, and outcome assessors)
- Sample Size
- 1362
- Follow-up
- 90 days
- Centers
- 106
- Countries
- China
Primary Outcome
Definition: Functional independence at 90 days (modified Rankin Scale score 0-2)
| Control | Intervention | HR/OR | P-value |
|---|---|---|---|
| 49.6% (333/671) | 55.0% (379/689) | - (1.00 to 1.23) | 0.05 |
Limitations & Criticisms
- Marginal statistical significance for primary outcome (P=0.05) suggests borderline efficacy
- Conducted only in Chinese population, limiting generalizability to other ethnic groups
- Subgroup analysis showing benefit in mismatch patients was exploratory and requires validation
- No assessment of cost-effectiveness of the intervention
- The study did not prohibit intravenous thrombolysis, which may confound results
- Relatively short follow-up period (90 days) may not capture long-term outcomes
- The mechanism of benefit remains unclear - whether through neuroprotection or other pathways
Citation
BMJ. 2026 Jan 7;392:e086850