What is Laci-3? We plan to test if two drugs called cilostazol and isosorbide mononitrate can prevent problems with thinking, memory, more strokes and mobility, and dementia, which can occur after a lacunar stroke. Why are we doing this study?Lacunar stroke survivors are at risk of problems with thinking, memory, and walking and can sometimes lead to dementia.Lacunar strokes are caused when small blood vessels deep within the brain become damaged and do not work as well as before.There are no treatments yet to help the small blood vessels work better. As a result, damage to the brain may continue to build up.We have found two drugs that we think may reduce damage to the small blood vessels in the brain and therefore could prevent strokes and thinking problems due to small vessel disease.Cilostazol and isosorbide mononitrate were safe and well tolerated in patients after lacunar stroke in the LACI-2 study of 363 people. What is LACI-3?LACI-3 is a randomised controlled study.Participants will be randomly assigned to one of the four groups:They may be given cilostazol only.They may be given isosorbide mononitrate only.Both cilostazol and isosorbide mononitrate will be given.Neither cilostazol nor isosorbide mononitrate is given.Everyone gets guideline standard medical care.The research teams will follow-up each participant for 18 months to see how they get on.LACI-3 will tell us what future best medical care is. This article was published on 2025-05-29