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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Citicoline for Acute Ischemic Stroke: A Systematic Review and Formal Meta-analysis of Randomized, Double-Blind, and Placebo-Controlled Trials
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Citicoline for Acute Ischemic Stroke: A Systematic Review and Formal Meta-analysis of Randomized, Double-Blind, and Placebo-Controlled Trials

机译：Citicoline治疗急性缺血性中风：随机，双盲和安慰剂对照试验的系统评价和形式荟萃分析。

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Background: Citicoline is a drug approved for the treatment of acute ischemic stroke. Although evidence of its efficacy has been reported, recently published results of a large placebo-controlled clinical trial did not show differences. This study aims to assess whether starting citicoline treatment within 14 days after stroke onset improves the outcome in patients with acute ischemic stroke, as compared with placebo. Methods: A systematic search was performed to identify all published, unconfounded, randomized, double-blind, and placebo-controlled clinical trials of citicoline in acute ischemic stroke. Results: Ten randomized clinical trials met our inclusion criteria. The administration of citicoline was associated with a significant higher rate of independence, independently of the method of evaluation used (odds ratio [OR] 1.56, 95% confidence interval [CI] = 1.12-2.16 under random effects; OR 1.20, 95% CI = 1.06-1.36 under fixed effects). After studying the cumulative meta-analysis, and with the results obtained with the subgroup of patients who were not treated with recombinant tissue plasminogen activator (rtPA) (OR 1.63, 95% CI = 1.18-2.24 under random effects; OR 1.42, 95% CI = 1.22-1.66 under fixed effects), our hypothesis of dilution of the effect of citicoline was confirmed. When we analyzed the effect of citicoline in patients who were not treated with rtPA and were receiving the highest dose of citicoline started in the first 24 hours after onset, based on more recent trials, there was no heterogeneity, and the size of the effect has an OR of 1.27 (95% CI = 1.05-1.53). Conclusions: This systematic review supports some benefits of citicoline in the treatment of acute ischemic stroke. But, on top of the best treatment available (rtPA), citicoline offers a limited benefit.
机译：背景：Citicoline是一种批准用于治疗急性缺血性中风的药物。尽管已经报道了其功效的证据，但最近发表的一项大型安慰剂对照临床试验的结果并未显示出差异。这项研究旨在评估与安慰剂相比，卒中发作后14天内开始胞磷胆碱治疗是否可以改善急性缺血性卒中患者的预后。方法：进行系统搜索以鉴定所有胞磷胆碱在急性缺血性卒中中已发表，无混淆，随机，双盲和安慰剂对照的临床试验。结果：十项随机临床试验符合我们的纳入标准。胞磷胆碱的给药具有较高的独立性，独立于所使用的评估方法（随机比值比[OR] 1.56，95％置信区间[CI] = 1.12-2.16; OR 1.20，95％CI =固定效果下的1.06-1.36）。在研究了累积的荟萃分析之后，获得了未经重组组织纤溶酶原激活剂（rtPA）治疗的患者亚组的结果（OR 1.63，95％CI = 1.18-2.24;随机效应; OR 1.42，95％在固定作用下CI = 1.22-1.66），证实了我们对胞磷胆碱作用稀释的假设。根据最近的研究，当我们分析胞磷胆碱对未经rtPA治疗且在发病后头24小时内开始接受最高剂量胞磷胆碱的患者的作用时，没有异质性，并且作用的大小OR为1.27（95％CI = 1.05-1.53​​）。结论：该系统评价支持胞磷胆碱在治疗急性缺血性中风中的某些益处。但是，除了可获得的最佳治疗（rtPA）之外，胞磷胆碱的益处有限。

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