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Corticosteroids for acute ischaemic stroke
N Qizilbash1, S L Lewington, J M Lopez-Arrieta
1GlaxoSmithKline, New Frontiers Science Park, Third Avenue, Harlow, Essex, UK, CM19 5AW. nawab.qizilbash-1@gsk.com
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Corticosteroids do not show a benefit in reducing death or improving functional outcomes for acute ischemic stroke patients. More evidence is needed to evaluate their effectiveness and safety in this condition.
Area of Science:
- Neurology
- Clinical Medicine
- Pharmacology
Background:
- Ischemic stroke often causes brain swelling due to cytotoxic edema, linked to cell membrane dysfunction.
- Corticosteroids are being investigated for their potential to reduce swelling and improve stroke outcomes.
Purpose of the Study:
- To systematically review the efficacy of corticosteroid treatment in acute presumed ischemic stroke.
Main Methods:
- Searched the Cochrane Stroke Group trials register and contacted investigators.
- Included randomized trials comparing corticosteroids with placebo in acute ischemic stroke, with treatment initiated within 48 hours.
- Two independent reviewers assessed trial quality and extracted data.
Main Results:
- Seven trials with 453 participants were analyzed; most lacked quality details.
- No significant difference in one-year mortality (OR 1.08, 95% CI 0.68-1.72) was observed.
- Functional outcomes and neurological impairment data were inconclusive due to inconsistent reporting and pooling difficulties; adverse effects included minor gastrointestinal bleeds and infections.
Conclusions:
- Insufficient evidence exists to support or refute the use of corticosteroids for acute presumed ischemic stroke.
- Current findings indicate no clear benefit, and further research is required to establish efficacy and safety.