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Limited evidence suggests buflomedil may reduce death or disability in acute ischaemic stroke patients. However, more high-quality research is needed to confirm buflomedil

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Few effective treatments exist for acute ischemic stroke.
  • Buflomedil, a vasoactive agent, shows potential for cerebrovascular diseases.
  • Buflomedil is not currently approved for clinical stroke treatment.

Purpose of the Study:

  • To evaluate the efficacy and safety of buflomedil for acute ischemic stroke.
  • To synthesize evidence from randomized controlled trials (RCTs) on buflomedil's use in stroke patients.

Main Methods:

  • Comprehensive search of multiple databases including Cochrane, MEDLINE, EMBASE, and Chinese databases.
  • Inclusion of 26 RCTs (2756 participants) comparing buflomedil with placebo or usual care.
  • Primary outcome: long-term death or disability. Secondary outcomes: short-term death, disability, neurological deficits, and adverse events.
  • Meta-analysis for death and neurological deficits; narrative reporting for disability and adverse events.
  • Subgroup analyses based on time since stroke, delivery route, dose, and duration.

Main Results:

  • All included trials were conducted in China, with participants being inpatients within days of stroke onset.
  • One trial indicated a potential reduction in death or disability with buflomedil (RR 0.71, 95% CI 0.53 to 0.94), but evidence quality was low.
  • No robust evidence was found for short-term outcomes (death, disability, neurological deficits).
  • Adverse events were reported in 11 trials (1046 participants), with 38 events in the buflomedil group versus two in the control group.
  • Overall evidence quality for all outcomes was low according to GRADE principles.

Conclusions:

  • Insufficient evidence currently supports the use of buflomedil for acute ischemic stroke treatment.
  • The findings highlight the need for adequately powered randomized controlled trials.
  • Further research is warranted to definitively establish buflomedil's efficacy and safety profile.