WSC 2026 | LACI-2 six-month findings and looking forward to LACI-3 for lacunar stroke prevention

This is like a subgroup analysis of the LACI-2 trial and the LACI-2 trial was the precursor to the big Phase III confirmatory LACI-3 trial that we’re doing at the moment and it’s testing two of the drugs that I mentioned in the first question, cilostazol and isosorbide mononitrate, and LACI-2 actually went on for a year, and the primary results were at one year, and I think what the six-month data show is that the effects that we saw at one year were already beginning to emerge at six months, which is encouraging because it doesn’t mean that six months is long enough, it just means that actually what you were seeing at one year, it kind of helps to make it more likely that it’s the true result because you’re starting to see a similar pattern even as early as six months, which is, you know, it’s encouraging. In the LACI-3 trial, we’re actually going for 18 months because we want to be sure that we’re detecting useful effects. You know, small vessel disease is a long-term condition. And if the results are positive, then it would mean that people would be being expected to take one or other or both of these tablets potentially for the rest of their life. And you don’t want to do that just on the basis of six months or a year. You want to know that this stuff works over a good period of time. So I think the six-month data are very encouraging. Put it this way, it’s good that they didn’t go in the opposite direction. But anyway, they seem to support the general direction of travel of the accumulating evidence. I think for a long term trial six months is not long enough and fortunately we had 12 month data and they were even stronger. But on the other hand it does mean that you might get a signal within six months of something positive happening if you were looking to sort of screen compounds and whether you should take them further or not so it also helps to inform potential future like for example testing on a sort of trial platform where you might want to be able to screen drugs and drop them early if they weren’t showing any signal at all you might say okay well we can probably do that at six months or no, I think it’s too early to do that. But I think they’re encouraging results. But this is a long term condition.

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