Clinical observation in edaravone treatment for acute cerebral infarction

Sun, Zhengyi; Xu, Qingmei; Gao, Guan-ran; Zhao, Mingli; Sun, Chongqi

doi:10.4103/njcp.njcp_367_18

Cited by 38 publications

(22 citation statements)

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“…After excluding commentaries, conference abstracts, reviews and meta‐analyses, non‐English articles, non‐SCI studies, and studies not related to the application of edaravone or MCI‐186 in the treatment of stroke, brain infract, cerebral infraction, cerebrovascular disease or brain attack, 25 articles were downloaded for further selection. Finally, 7 studies 18 , 19 , 20 , 21 , 22 , 23 , 24 were included for this meta‐analysis. The flow diagram of the study selection is presented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Three RCTs 18 , 20 , 22 investigated patients with a treatment time window within 24 h, and three RCTs 19 , 21 , 22 investigated patients with stable vital signs who were admitted to hospitals during 24‐72 hours after the onset of stroke. Five RCTs 19 , 21 , 22 , 23 , 24 investigated patients treated with edaravone for two weeks and the other two RCTs included patients treated with edaravone for one week. Four RCTs 18 , 20 , 21 , 22 evaluated outcome at the long‐term follow‐up, namely three months or later.…”

Section: Resultsmentioning

confidence: 99%

“…Four RCTs 18 , 20 , 21 , 22 evaluated outcome at the long‐term follow‐up, namely three months or later. The other three RCTs 19 , 23 , 24 made an assessment at two weeks follow‐up. The detailed quality assessment of the included studies is presented in Table 2 and Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Four RCTs 18 , 21 , 22 , 23 including 466 patients reported the incidence of adverse events during the treatment. In the control group, any treatment‐related adverse events were found in 29 (12.1%) patients among 226 participants.…”

Section: Resultsmentioning

confidence: 99%

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Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Chen

Lin

et al. 2021

J Clin Pharm Ther

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What is known and objective Edaravone is a new antioxidant and hydroxyl radical scavenger. Although there is evidence that it improves clinical outcomes of patients with acute ischaemic stroke (AIS), it is not yet widely accepted for treatment of AIS in Western countries. We further investigated the efficacy and safety of edaravone through this meta‐analysis of randomized controlled clinical trials (RCTs). Method Pubmed, Embase, Web of Science and Cochrane Library were screened up to December 2020 for original articles from SCI journals that published in English. RCTs that compared edaravone versus placebo or no intervention in adult patients and reported the efficacy or safety of edaravone were regarded as eligible. Mortality was regarded as the primary outcome and the improvement of neurological impairment was regarded as the secondary outcome. Safety evaluation was conducted according to the incidence of adverse events. Review Manager 5.3 was employed to perform the assessment of the risk of bias and data synthesis. The Cochrane risk of bias tool for randomized controlled trials was employed to assess the risk of bias. Results and discussion Seven randomized controlled trials with 2069 patients were included. For the incidence of mortality, the pooled RR for studies that evaluated edaravone after three‐month follow‐up was 0.55 (95% Cl, 0.43‐0.7, I2 = 0, P < 0.01). The pooled RR for improvement of neurological impairment at the three months follow‐up was 1.54 (95% CI, 1.27‐1.87, I2 = 0, P < 0.01) in four RCTs. On subgroup analysis of studies that were conducted in Asia, the RR was 1.56 (95% CI, 1.27‐1.90, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in Europe was 1.32 (95% CI, 0.64‐2.72; P = 0.45); the pooled RR for studies that used edaravone for two weeks was 1.42 (95% CI, 1.10 to 1.83, I2 = 0%; P < 0.01); the pooled RR for studies that used edaravone for one week was 1.64 (95% CI, 1.24‐2.16, I2 = 0%; P < 0.01); the pooled RR for studies that conducted in patients with mean age equal to or over 60 years was 1.52 (95% CI, 1.24‐1.87, I2 = 0%; P < 0.01); and the pooled RR for studies that conducted in patients with mean age less than 60 was 1.80 (95% CI, 1.05‐3.08, I2 = 0%; P = 0.03). For the incidence of any treatment‐related adverse events, the pooled RR for studies that evaluated edaravone during treatment was 0.83 (95% CI, 0.51‐1.34, I2 = 0, P = 0.43). The difference of the incidence of any treatment‐related adverse events between two groups was not statistically significant. What is new and conclusion The limited studies indicate that edaravone can improve neurological impairment with a survival benefit at three‐month follow‐up, regardless of the mean age and course of treatment. It is worthy of promotion in the clinical treatment of AIS in Asian countries. More well‐designed RCTs with larger sample sizes are needed to determine the benefits of edaravone in patients from Western countries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Chen

Lin

et al. 2021

J Clin Pharm Ther

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“…Antioxidant Drugs. Edaravone, a new antioxidant and hydroxyl radical scavenger, is the novel scavenger for clinical use, mainly for nervous system diseases [327,328]. In vitro and in vivo data of edaravone suggests that it may possess broad free radical scavenging activity and protect neurons, glia, and vascular endothelial cells against oxidative stress [329].…”

Section: Clinical Approaches Towards Oxidative Stress In Neurological Diseasesmentioning

confidence: 99%

Oxidative Stress-Mediated Blood-Brain Barrier (BBB) Disruption in Neurological Diseases

Song

Zhang

et al. 2020

Oxidative Medicine and Cellular Longevity

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The blood-brain barrier (BBB), as a crucial gate of brain-blood molecular exchange, is involved in the pathogenesis of multiple neurological diseases. Oxidative stress is caused by an imbalance between the production of reactive oxygen species (ROS) and the scavenger system. Since oxidative stress plays a significant role in the production and maintenance of the BBB, the cerebrovascular system is especially vulnerable to it. The pathways that initiate BBB dysfunction include, but are not limited to, mitochondrial dysfunction, excitotoxicity, iron metabolism, cytokines, pyroptosis, and necroptosis, all converging on the generation of ROS. Interestingly, ROS also provide common triggers that directly regulate BBB damage, parameters including tight junction (TJ) modifications, transporters, matrix metalloproteinase (MMP) activation, inflammatory responses, and autophagy. We will discuss the role of oxidative stress-mediated BBB disruption in neurological diseases, such as hemorrhagic stroke, ischemic stroke (IS), Alzheimer’s disease (AD), Parkinson’s disease (PD), traumatic brain injury (TBI), amyotrophic lateral sclerosis (ALS), and cerebral small vessel disease (CSVD). This review will also discuss the latest clinical evidence of potential biomarkers and antioxidant drugs towards oxidative stress in neurological diseases. A deeper understanding of how oxidative stress damages BBB may open up more therapeutic options for the treatment of neurological diseases.

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RETRACTED ARTICLE: Treatment of vertebrobasilar artery ectasia based on MR high resolution vascular wall imaging: an ultra small Fe3O4 nanoparticle labeling method

Xiao,

Kang,

Geng

et al. 2023

Soft Comput

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Clinical observation in edaravone treatment for acute cerebral infarction

Cited by 38 publications

References 1 publication

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: A meta‐analysis of randomized controlled trials

Oxidative Stress-Mediated Blood-Brain Barrier (BBB) Disruption in Neurological Diseases

RETRACTED ARTICLE: Treatment of vertebrobasilar artery ectasia based on MR high resolution vascular wall imaging: an ultra small Fe3O4 nanoparticle labeling method

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