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Updated: Sep 6, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Actovegin in the management of patients after ischemic stroke: A systematic review
Philip la Fleur1, Ardak Baizhaxynova1, Emily Reynen2
1School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.
Insights
Actovegin, a calf blood hemodialysate, shows uncertain benefits for ischemic stroke patients. The review found no consistent evidence of improvement and noted potential risks, highlighting the need for more rigorous trials.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Actovegin, a hemoderivative, has been used for neurological and vascular conditions.
- Its efficacy in treating ischemic stroke remains a subject of investigation.
Purpose of the Study:
- To systematically review the effects of Actovegin in patients post-ischemic stroke.
- Evaluate the available evidence on Actovegin's therapeutic value and safety.
Main Methods:
- Systematic search of major databases (MEDLINE, PubMed, Cochrane, Embase) up to October 2021.
- Inclusion of clinical trials and observational studies with control groups.
- Screening of 220 unique records, with 5 studies (4 observational, 1 RCT) meeting criteria.
Main Results:
- Total of 3879 patients studied; 720 received Actovegin.
- No consistent evidence of improved survival, quality of life, or neurological outcomes.
- One study indicated potential cognitive improvement (ADAS-cog+), but clinical relevance is uncertain.
- One study reported increased risk of recurrent stroke or hemorrhage with Actovegin.
Conclusions:
- The therapeutic benefits of Actovegin for ischemic stroke are not clearly established.
- Potential risks associated with Actovegin use in stroke patients warrant consideration.
- Further high-quality clinical trials are necessary to determine Actovegin's role in ischemic stroke management.
Background:
Actovegin is a hemodialysate of calf's blood and has been used for several decades in the countries of Central Asia, East Asia, Russia and some European countries. It has been used to treat patients with various neurological conditions, vascular disorders, and ischemic stroke.
Objectives:
To perform a systematic review to evaluate the effect of Actovegin in patients who have suffered an ischemic stroke.
Methods:
A search of MEDLINE, PubMed, Cochrane and Embase was carried out from inception to October 10, 2021 for clinical trials and observational studies with a control group, published in English or Russian.
Results:
Of 220 identified unique records, 84 full-text articles were screened, and 5 studies were selected that met the inclusion criteria. This included 4 observational studies with control groups and one randomized, placebo-controlled clinical trial. These studies enrolled a total of 3879 patients of which 720 patients received Actovegin administered intravenously and/or orally for a duration ranging from 10 to 180 days. Because of study heterogeneity, meta-analysis was not performed. No consistent evidence on improved survival, quality of life, neurologic symptoms, activities of daily living or disability was identified. One study showed statistically significant improvements in the Alzheimer's Disease Assessment Scale, cognitive subscale, extended version (ADAS-cog+) for Actovegin compared with placebo at 6 months but the clinical relevance of this change is uncertain. One study reported a higher incidence of recurrent ischemic stroke, transient ischemic attack or intracerebral hemorrhage in patients taking Actovegin compared to placebo.
Conclusions:
The benefits of Actovegin are uncertain and that there is potential risk of harm in patients with stroke. More evidence is needed from rigorously designed clinical trials to justify the role of Actovegin in patients with ischemic stroke.
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