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Published Online
on February 26, 2009

Stroke. 2009
Published online before print February 26, 2009, doi: 10.1161/STROKEAHA.108.541128
A more recent version of this article appeared on June 1, 2009
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Submitted on October 27, 2008
Revised on December 10, 2008
Accepted on December 15, 2008

Update of the Stroke Therapy Academic Industry Roundtable Preclinical Recommendations

Marc Fisher MD*; Giora Feuerstein MD; David W. Howells PhD; Patricia D. Hurn PhD; Thomas A. Kent MD; Sean I. Savitz MD; Eng H. Lo PhD; for the STAIR Group

From the Department of Neurology (M.F.), University of Massachusetts Medical School, Worcester, Mass; Wyeth Pharmaceuticals (G.F.), National Stroke Research Institute & University of Melbourne, Melbourne, Australia; Department of Medicine (D.W.H.), Department of Anesthesiology (P.D.H.), University of Oregon Health Sciences Center, Portland, Ore; Department of Neurology (T.A.K.), Baylor College of Medicine; Department of Neurology (S.I.S.), University of Texas, Houston Medical School, Houston, Tex; Department of Radiology (E.H.L.), Harvard Medical School, Cambridge, Mass.

* To whom correspondence should be addressed. E-mail: fisherm{at}ummhc.org.

Abstract—The initial Stroke Therapy Academic Industry Roundtable (STAIR) recommendations published in 1999 were intended to improve the quality of preclinical studies of purported acute stroke therapies. Although recognized as reasonable, they have not been closely followed nor rigorously validated. Substantial advances have occurred regarding the appropriate quality and breadth of preclinical testing for candidate acute stroke therapies for better clinical translation. The updated STAIR preclinical recommendations reinforce the previous suggestions that reproducibly defining dose response and time windows with both histological and functional outcomes in multiple animal species with appropriate physiological monitoring is appropriate. The updated STAIR recommendations include: the fundamentals of good scientific inquiry should be followed by eliminating randomization and assessment bias, a priori defining inclusion/exclusion criteria, performing appropriate power and sample size calculations, and disclosing potential conflicts of interest. After initial evaluations in young, healthy male animals, further studies should be performed in females, aged animals, and animals with comorbid conditions such as hypertension, diabetes, and hypercholesterolemia. Another consideration is the use of clinically relevant biomarkers in animal studies. Although the recommendations cannot be validated until effective therapies based on them emerge from clinical trials, it is hoped that adherence to them might enhance the chances for success.


Key words: preclinical • stroke models • therapy