Skip to main content
. Author manuscript; available in PMC: 2022 Aug 1.
Published in final edited form as: Stroke. 2021 Jul 22;52(9):3063–3071. doi: 10.1161/STROKEAHA.121.034947

Table 2. Revised STAIR Recommendations.

After STAIR XI all prior recommendations were revised, consolidated and updated. Revised STAIR recommendations are separated for two experimental purposes. A. Candidate Treatment Qualification, which means early research and development of a novel, putative treatment. B. Preclinical Assessment and Validation, which means demonstrating efficacy in stroke models that have a likelihood of predicting success in subsequent patient clinical trials.

A. Candidate Treatment Qualification
Dose Response Treatment effect varies with changes in dose
Time Window Treatment remains effective when administered after clinically relevant delay times
Histological and behavioral outcomes Beneficial effects can be demonstrated using measures of behavior and tissue damage
Target Engagement Candidate treatment reaches presumed target and causes expected physiological effects
Barrier Penetration Candidate treatment enters brain
B. Preclinical Assessment and validation
Sample Size Sample size should be pre-specified based on known or assumed standard deviation and predicted effect size
Inclusion/Exclusion criteria Effective MCA occlusion is confirmed using laser Doppler or other flowmetry or symptom severity
Randomization Animals are randomized prior to initiation of any study procedures
Allocation concealment Surgeon performing stroke remains unaware of treatment assignment
Reporting on excluded animals Subjects lost at each experimental step after randomization are summarized
Blinded assessment of outcome Investigators remain unaware of treatment assignment during all assessments
Age Consider effects of age on outcome
Sex Males and females should be assessed. Dose response differences between sexes should be determined
Co-morbidities Ideal models of stroke co-morbid conditions (e.g., diabetes or hypertension) need to be refined
Multiple laboratories Concordant effects should be demonstrated across multiple laboratories using similar methods.
Gyrencephalic species Demonstration of efficacy in gyrencephalic species, particularly non-human primates may contribute to predicting clinical efficacy
Circadian Effects Preclinical testing of therapies during the awake phase of rodent models should be considered.
Reporting of investigator or institutional conflicts of interest Investigator and institution conflicts are reported and managed

NB: STAIR recommendations are not guidelines or protocols, but rather consensus suggestions from an expert panel for investigators to consider.