Edaravone confers neuroprotection in stroke patients

Edaravone appears to be safe and effective in the treatment of patients with ischaemic stroke, yielding improvements in activities of daily living and neurologic deficits in the short term, a study has found.

Researchers conducted a systematic review and meta-analysis of studies that evaluated the efficacy and tolerability of edaravone, with or without thrombolytic therapy, in acute ischaemic stroke. They searched multiple online databases for relevant studies.

Nine randomized controlled trials and four cohort studies, involving a total of 2,102 patients, were included in the meta-analysis.

Pooled data revealed that relative to control treatment, edaravone monotherapy produced significant improvements in several outcomes on short-term follow-up. These outcomes included Barthel Index of functioning in activities for daily living (mean difference [MD], 23.95, 95 percent confidence interval [CI], 18.48–29.41; p<0.001) and neurologic deficit (measured using the National Institutes of Health Stroke Scale score; MD, –3.49, 95 percent CI, –5.76 to 1.22; p=0.003).

However, edaravone had no favourable effect on death or disability risk (RR, 0.75, 95 percent CI, 0.45–1.23; p=0.25) on long-term follow-up.

When added to thrombolytic therapy, edaravone led to significant improvements in recanalization rate (RR, 1.71, 95 percent CI, 1.05–2.77; p=0.03) and neurologic deficit (MD, 3.97, 95 percent CI, 5.14–2.79; p<0.001), without increasing the prevalence of bleeding events (RR, 1.11, 95 percent CI, 0.76–1.62; p=0.59).

However, edaravone plus thrombolytic therapy likewise showed no significant effect on death or disability (RR, 0.85, 95 percent CI, 0.69–1.04; p=0.12).

Larger-scale clinical trials are needed to establish the long-term effects of edaravone in acute ischaemic stroke.