Letter by Rustemi Regarding Article, “Randomized, Open-Label, Phase 1/2a Study to Determine the Maximum Tolerated Dose of Intraventricular Sustained Release Nimodipine for Subarachnoid Hemorrhage (NEWTON [Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity After Subarachnoid Hemorrhage])”
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To the Editor:
Hänggi et al1 report the results of a randomized, open-label, phase 1/2a study to determine the maximum tolerated dose of intraventricular sustained release nimodipine for subarachnoid hemorrhage (SAH) compared with enteral nimodipine. Nimodipine is the only vasodilatator approved for SAH as supported by outcome evidence. The administration route is generally enteral or intravenous. Locoregional intra-arterial infusion is used to reverse established angiographic vasospasm. The intraventricular administration is novel. The rationale was to reduce systemic hypotension and increase efficacy. Intravenous administration was compared with enteral administration. Studies have substantially shown no difference in …