Stroke is a serious condition where brain cells die due to interrupted blood flow, ranking among the leading causes of death globally. Large vessel occlusion (LVO) is the most severe subtype of stroke, carrying the highest risk of mortality and disability. Endovascular therapy (EVT), a procedure to reopen blocked vessels, has become the standard treatment for LVO. However, many patients who undergo EVT still experience significant neurological impairment, often resulting from prolonged blood supply interruption and post-stroke neuroinflammation.

Previous research by Dr. Ho Ko at the Gerald Choa Neuroscience Institute (GCNI) demonstrated that glucagon-like peptide-1 receptor agonists (GLP-1RAs) have neuroprotective effects in animal aging models. Yet, it remained unclear whether GLP-1RAs could benefit patients during hyperacute stroke. At the late-breaking session in the International Stroke Conference in February 2025, Dr. Bonaventure Ip from the GCNI presented preliminary findings from a phase 2 randomized trial led by CUHK. The study suggests that semaglutide, a GLP-1RA, administered before and for seven days after EVT, may reduce functional disability. This trial, conducted across four hospitals in the Hong Kong Special Administrative Region and mainland China, involved 140 patients with LVO who were scheduled to undergo EVT. Compared to patients who received EVT alone, semaglutide was associated with a lower risk of brain bleeding after the procedure. Additionally, among patients who did not receive intravenous thrombolysis, semaglutide recipients showed better neurological recovery compared to standard therapy.

Although the study's relatively small sample size precludes a definitive conclusion, it lays the groundwork for future investigations into the interactions between intravenous thrombolytic agents and semaglutide. This foundation will also support a phase 3, nationwide randomized controlled trial to further explore the effects of semaglutide on patients eligible for EVT. The research underscores the GCNI's commitment to fostering translational research and collaboration with mainland China. By bridging the gap between laboratory findings and clinical applications, the GCNI aims to accelerate the development of innovative treatments. The ongoing collaboration between Hong Kong and mainland China highlights the potential for regional partnerships to drive medical advancements. These efforts hold promise for improving stroke treatment outcomes and enhancing the quality of life for those affected by this condition.