Edaravone for acute ischemic stroke - Systematic review with meta-analysis.

• Type: Article in International Scientific Journal
• Date: 2022

Authors

Fidalgo, M (Author) Other; Ricardo Pires, J (Author) Other; Viseu, I (Author) Other; Magalhães, P (Author) Other; Gregório, H (Author) Other; Afreixo, V (Author) Other; Gregório, T (Author) FMUP

Journal

Title: Clinical Neurology and Neurosurgery

Vol. 219

ISSN: 0303-8467

Publisher: Elsevier

Indexing

Scopus

Other information

Authenticus ID: P-00W-STD

DOI: 10.1016/j.clineuro.2022.107299

Abstract (EN): Introduction: Ischemic stroke is a major cause of death and disability. Despite major advances in reperfusion therapies, most patients don¿t benefit from these treatments as the time window for such interventions is limited. Therefore, other treatment options are desirable. Edaravone has been demonstrated in previous studies to reduce neurologic deficits in stroke patients. Objective: To test the hypothesis that edaravone reduces functional dependence in ischemic stroke patients. Material and methods: Systematic review and meta-analysis of randomized controlled trials and observational studies comparing edaravone to placebo in adult patients with ischemic stroke. The efficacy outcomes of interest were good and excellent functional outcomes at 90 days, defined as modified Rankin Scale (mRS) scores of 0¿2 and 0¿1 respectively. The safety outcomes of interest were intracranial hemorrhage and mortality. Results: 19 studies were included. Edaravone treatment was associated with improved chances of 90-day good (OR=1.31, 95% CI 1.06¿1.67) and excellent (OR=1.26, 95% CI 1.04¿1.54) functional outcomes. Mortality was also lower in edaravone treated patients (OR=0.50, 95% CI 0.45¿0.56). There were no differences in terms of intracranial hemorrhage. Most studies were observational and performed in Asian populations, especially Japan. Heterogeneity was high for all outcomes but reduced when analysis was restricted to randomized trials. Conclusion: Edaravone is a promising treatment for ischemic stroke patients, with a more favorable time window. However, more randomized studies including patient populations outside Asia are required to confirm this hypothesis. © 2022 Elsevier B.V.

Language: English

Type (Professor's evaluation): Scientific