Synergistic effects of neuroprotective drugs with intravenous recombinant tissue plasminogen activator in acute ischemic stroke: A Bayesian network meta-analysis

Where is the protocol for this located so stroke survivors can inform their stroke medcal 'professionals' about using this?  Oh, you didn't create one, did you? YOU'RE FIRED!

You'll have to ask your competent? doctor why the hell edaravone is approved in Japan since 2001 but not the US.

Has your stroke hospital done anything with edaravone in the last decade?

 

• edaravone (12 posts to November 2011)

The latest here:

 Synergistic effects of neuroprotective drugs with intravenous recombinant tissue
plasminogen activator in acute ischemic stroke: A Bayesian network meta-analysis

RESEARCH ARTICLE
Synergistic effects of neuroprotective drugs
with intravenous recombinant tissue
plasminogen activator in acute ischemic
stroke: A Bayesian network meta-analysis
Chun DangID1, Qinxuan Wang2, Yijia Zhuang2, Qian Li3, Yaoheng LuID4☯*,
Ying XiongID1☯*, Li Feng5☯*
1 Department of Periodical Press/Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan
University, Chengdu, China, 2 West China Hospital, West China School of Medicine, Sichuan University,
Chengdu, China, 3 Department of Neurology, The Second Affiliated Hospital of Harbin Medical University,
Harbin, China, 4 Department of General Surgery, Chengdu Integrated Traditional Chinese Medicine and
Western Medicine Hospital, Chengdu, China, 5 Department of General Surgery and Regenerative Medicine
Research Center, West China Hospital, Sichuan University, Chengdu, China
☯ These authors contributed equally to this work.
* fengli@scu.edu.cn (LF); 61711445@qq.com (YX); lyh93@cdutcm.edu.cn (YL)

Abstract

Neuroprotective drugs as adjunctive therapy for adults with acute ischemic stroke (AIS)
remains contentious. This study summarizes the latest evidence regarding the benefits of
neuroprotective agents combined with intravenous recombinant tissue plasminogen activa-
tor (rt-PA) intravenous thrombolysis. This study conducted a structured search of PubMed,
the Cochrane Library, EMBASE, Wanfang Data, and CNKI databases from their inception
to March 2024. Grey literature was also searched. The outcomes included efficacy (National
Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) score) and safety
(rate of adverse reactions). A total of 70 randomized controlled trials were selected for this
network meta-analysis (NMA), encompassing 4,140 patients with AIS treated using different
neuroprotective agents plus RT-PA, while 4,012 patients with AIS were in control groups.
The top three treatments for NIHSS scores at the 2-week follow-up were Edaravone Dex-
borneo with 0.9 mg/kg rt-PA, Edaravone with 0.9 mg/kg rt-PA, and HUK with 0.9 mg/kg rt-
PA. HUK with 0.9 mg/kg rt-PA, Dl-3n-butylphthalide with 0.9 mg/kg rt-PA, and Edaravone
Dexborneo with 0.9 mg/kg rt-PA were ranked the top three for BI scores at the 2-week fol-
low-up. The top three treatments with the lowest adverse effect rates were 0.6 mg/kg rt-PA,
HUK with 0.9 mg/kg rt-PA, and Edaravone Dexborneo with 0.9 mg/kg rt-PA due to their
excellent safety profiles. Compared to rt-PA alone, the combination treatments of Edara-
vone+rt-PA, Edaravone Dexborneol+rt-PA, HUK+rt-PA, Dl-3n-butylphthalide+rt-PA, and
Ganglioside GM1+rt-PA have shown superior efficacy. This NMA suggest that combination
therapies of neuroprotective agents and rt-PA can offer better outcomes for patients with
AIS. The results support the potential integration of these combination therapies into stan-
dard AIS treatment, aiming for improved patient outcomes and personalized therapeutic
approaches.