Stroke Clinical Trials in India: Bridging the Gaps in Public Health Outreach.

Abstract

Abstract: For stroke treatment and rehabilitation, various types of medicine and therapies are available; however, they need to evolve continuously through evidence-based research. The present study analyzed clinical trials on stroke in India, registered at the Clinical Trials Registry of India (CTRI) to delineate the trends, advances, gaps, and challenges on stroke from clinical perspectives. The study analyzes randomized clinical trials (RCTs) on stroke, registered at the CTRI database, since the inception of CTRI (2007) till July 2025. Search was done using the keywords "stroke," "Brain attack," and "cerebrovascular accident" in the fields "Scientific Title," "Public Title," and "Health conditions." A total of 2102 trials related to stroke were retrieved from the CTRI database that reduces to 1109 after removing duplicates. Out of these, only 578 trials were interventional RCTs, and 560 trials were being conducted in India. The study revealed: (i) major contribution of the private sector, (ii) more public hospitals involved in the multicentric/multi-intervention RCT, (iii) disparity in RCTs across states, (iv) maximum (62%) of studies were of satisfactory quality as per modified Jaded scale, (v) public hospitals performed slightly better in terms of quality parameters and sample size, and (vi) physiotherapy dominated among types of interventions being tested. Representation of the population of all states is necessary so that strategies may be developed on regional basis. Prioritizing stroke-prevalent regions for clinical trial activities can bridge critical gaps in public health outreach and empower local communities. Participation of government institutes and sponsorship must be increased, and collaboration should be encouraged.