In this bonus episode of the NCS Podcast Hot Topics series, host Rich Choi, MD, continues his conversation with Andrew Webb, PharmD, with a preview of "Subarachnoid Hemorrhage: Clazosentan vs. Fasudil for Vasospasm Prevention (SAVIOR) Study: Study Protocol for a Prospective, Multicenter, Randomized Trial," published in Neurocritical Care.

They review the history of nimodipine as the standard treatment for improving outcomes after aneurysmal subarachnoid hemorrhage and compare its mechanism with those of fasudil and clazosentan. Dr. Webb explains why fasudil is commonly used for vasospasm prevention in Japan and discusses previous research showing that clazosentan can reduce vasospasm without consistently improving functional outcomes when added to nimodipine.

The conversation also explores how the SAVIOR trial will directly compare clazosentan and fasudil in a nimodipine-free population. They consider whether the trial could establish a preferred approach in Japan, what its results might mean for practice elsewhere and whether clazosentan may eventually have a role for selected patients who cannot tolerate nimodipine.

The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.