Free Radical Scavengers For Ischemic Stroke: A Systematic Review And Meta-analysis

【Purpose】Stroke remains the leading cause of death and disability. Unfortunately, it remains huge challenge for scientists and neurologists to find the successful treatment of ischemic stroke. Free radical scavengers seems promising pharmacotherapy candidate for acute ischemic stroke. Here we use systematic review and meta-analysis to demonstrate the efficacy and safety outcomes of free radical scavengers in randomised clinical trials ischemic stroke.【Methods】randomised clinical trials were identified from extensive search of Cochrane Central Register of Controlled Trials. PubMed and EMBASE. Only real randomised clinical trials and adult patients with ischemic stroke that fulfilled predefined criteria were eligible. We assessed the quality of research according Cochrane handbook as well as evaluated the quality of evidence for outcomes useing the GRADE system. We used RevMan5 to perform meta-analyses.【Results】We obtained 18 eligible trials. The qualities of evidence for results of dead or dependent and result of adverse event were high, result of death from all causes was moderate, result of proportion of patients with improvement of neurological deficit was very low. The meta-analyses results showed that free radical scavengers had no beneficial effort comparing with placebo on death from all causes (RR=1.01: 95%CI=[0.90,1.13]), proportion of patients with improvement of neurological deficit (sample size>600:RR=0.98; 95%CI=[0.92,1.04]:sample size<600:RR=1.24; 95%CI=[1.09,1.40])and adverse event (RR=0.98; 95%CI=[0.96,1.01]). Only on results of dead or dependent (RR=0.91; 95%CI=[0.85,0.97]),free radical scavengers performed better than placebo in ischemic stroke.【Conclusion】Our studies proved that according the randomised clinical trials we've searched, free radical scavenger had little effect on ischemic stroke.