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Angong Niuhuang Pill (ANP) is a classic Traditional Chinese Medicine (TCM) formula widely utilized for the emergency treatment of acute cerebrovascular diseases, including ischemic and hemorrhagic stroke, as well as other conditions involving high fever, coma, and convulsions. The formula traditionally consists of eleven ingredients: Calculus Bovis (cow bezoar), Cornu Bubali (water buffalo horn), Moschus (musk), Margarita (pearl), Cinnabaris (cinnabar), Realgar, Rhizoma Coptidis, Radix Scutellariae, Fructus Gardeniae, Radix Curcumae, and Borneolum Syntheticum. In the context of the **APEX-STROKE** trial led by **Fudan University**, the "Early" designation refers to a specific clinical protocol evaluating the hyper-acute administration of the drug, including pre-hospital sublingual suspension delivery in ambulances. ANP is hypothesized to exert neuroprotective effects by mitigating neuroinflammation, stabilizing the blood-brain barrier, and reducing cerebral edema through the modulation of pathways such as TLR4/NF-κB.
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