Edaravone for acute ischemic stroke - Systematic review with meta-analysis

Area of Science:

• Neurology
• Clinical Trials
• Pharmacology

Background:

• Ischemic stroke is a leading cause of death and disability worldwide.
• Current reperfusion therapies have limited time windows, necessitating alternative treatments.
• Edaravone has shown potential in reducing neurological deficits post-stroke.

Purpose of the Study:

• To evaluate the efficacy of edaravone in reducing functional dependence in ischemic stroke patients.
• To assess the impact of edaravone on functional outcomes and safety parameters.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials and observational studies.
• Included adult patients with ischemic stroke treated with edaravone versus placebo.
• Primary outcomes: modified Rankin Scale (mRS) scores (0-2 for good, 0-1 for excellent) at 90 days; safety outcomes: intracranial hemorrhage and mortality.

Main Results:

• Edaravone treatment was associated with improved 90-day good functional outcomes (OR=1.31) and excellent functional outcomes (OR=1.26).
• Mortality was significantly lower in patients receiving edaravone (OR=0.50).
• No significant difference in intracranial hemorrhage rates; high heterogeneity noted, reduced in randomized trials.

Conclusions:

• Edaravone demonstrates promise as a treatment for ischemic stroke, potentially offering a wider therapeutic time window.
• Further high-quality randomized controlled trials, particularly in non-Asian populations, are required to validate these findings.