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Cerebrolysin for acute ischaemic stroke
Liliya Eugenevna Ziganshina1,2, Tatyana Abakumova3, Charles Hv Hoyle1,4
1Cochrane Russia, Kazan, Russian Federation.
The Cochrane Database of Systematic Reviews
|July 15, 2020
Summary
Cerebrolysin likely offers no significant benefit for preventing death in acute ischemic stroke patients. However, it may increase the risk of non-fatal serious adverse events, warranting cautious use.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Cerebrolysin, a porcine brain-derived peptide mixture, is used for neuroprotection.
- It is prevalent in treating acute ischemic stroke in Eastern Europe, Asia, and post-Soviet countries.
- This review is an update on Cerebrolysin's efficacy and safety, first published in 2010.
Purpose of the Study:
- To evaluate the benefits and harms of Cerebrolysin in acute ischemic stroke treatment.
- To synthesize evidence from randomized controlled trials (RCTs) on Cerebrolysin's effectiveness.
- To assess safety profiles, including adverse events and mortality.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, Embase, etc.) and ongoing trials up to October 2019.
- Included RCTs comparing Cerebrolysin with placebo/no treatment initiated within 48 hours of stroke onset.
- Independently assessed trial quality, risk of bias, and applied GRADE criteria.
Main Results:
- Seven RCTs (1601 participants) were included; risk of bias varied across studies.
- Cerebrolysin showed little to no difference in all-cause mortality (RR 0.90, 95% CI 0.61 to 1.32).
- A potential increase in non-fatal serious adverse events was observed (RR 2.15, 95% CI 1.01 to 4.55), particularly with a 30 mL/10-day dosing schedule.
Conclusions:
- Moderate-quality evidence suggests Cerebrolysin has minimal to no benefit for all-cause mortality in acute ischemic stroke.
- Evidence indicates a potential increase in non-fatal serious adverse events with Cerebrolysin use.
- Further research may be needed to clarify the risk-benefit profile, especially concerning specific dosing regimens.
