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Meta-analysis of defibrase in treatment of acute cerebral infarction
Yi Guo1, Yan-fang Zuo, Qi-zhang Wang
1Department of Neurology, Second Affiliated Hospital of Jinan University, Shenzhen 518020, China. yi_g4326@yahoo.com.cn
Insights
Defibrase shows potential in treating acute cerebral infarction by reducing neurological deficits and plasma fibrinogen levels. This fibrinogen-depleting agent may inhibit stroke progression and prevent recurrence.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Fibrinogen-depleting agents show promise for cerebral ischemic disease treatment.
- Previous trials yielded varied outcomes due to differing regimens and doses.
- This study assesses defibrase efficacy and safety in acute cerebral infarction patients in China.
Purpose of the Study:
- To evaluate the efficacy and safety of defibrase in treating acute cerebral infarction.
- To analyze the impact of defibrase on neurological deficit scores and plasma fibrinogen levels.
- To determine defibrase's role in stroke management and prevention.
Main Methods:
- A systematic search of randomized controlled trials was conducted using the Chinese Hospital Knowledge Database and MEDLINE.
- Keywords included 'defibrase', 'acute cerebral infarction', 'cerebral ischemia', and 'stroke'.
- Meta-analysis was performed using RevMan software 4.2 on data from 14 studies (646 patients).
Main Results:
- Defibrase treatment significantly improved neurological deficit scores post-treatment (P=0.03).
- A significant reduction in plasma fibrinogen levels was observed after defibrase administration (P<0.00001).
- Trends suggested improvement in Barthel index (P=0.06), but pre-treatment NDS showed no significant difference (P=0.23).
Conclusions:
- Defibrase, at the studied doses and regimens in China, appears to possess anticoagulation properties.
- The agent may play a role in inhibiting stroke progression.
- Defibrase might also contribute to preventing stroke recurrence.
Background:
Fibrinogen-depleting agents are promising in the treatment of cerebral ischemic disease. They were studied by many trials, and the outcomes were different because of different regimens and different doses. In this study, we assessed the efficacy and safety of defibrase on acute cerebral infarction in China.
Methods:
A search using Chinese hospital knowledge database (CHKD) and MEDLINE database for randomized controlled trials was carried out. A CHKD (1994 June 2005) search was performed with the keyword "defibrase", then a second search for the keyword "acute cerebral infarction"; a MEDLINE search (1950 June 2005) was performed with the following keywords: [(cerebral ischemia), OR (acute cerebral infarction), OR (stroke)], AND [defibrase]. Meta-analysis was performed with RevMan software 4.2.
Results:
Included were 14 studies comparing the efficiency and safety of defibrase with other drugs in the treatment of acute cerebral infarction. Patients' records were pooled (total 646 patients; defibrase, n = 328, no defibrase n = 318). Neurological deficit score (NDS) before treatment showed weighted mean differences (WMD) = 0.95, 95% confidence interval (CI) = (-0.60, 2.50), P = 0.23; NDS after treatment showed WMD = -2.20, 95% CI = (-4.21, -0.18), P = 0.03; Barthel index at 3 months showed WMD = 4.45, 95% CI = (-0.13, 9.03), P = 0.06; the plasma fibrinogen level before treatment showed WMD = 0.02, 95% CI = (-0.16, 0.19), P = 0.86; plasma fibrinogen level after treatment showed WMD = -1.51, 95% CI = (-1.88, -1.15), P < 0.00 001.
Conclusions:
With the given dose and regimen of defibrase in China, defibrase may play a role of anticoagulation. It might inhibit the progression of stroke and prevent the recurrence of stroke.