Journal
CURRENT DRUG DELIVERY
Volume 14, Issue 6, Pages 853-860Publisher
BENTHAM SCIENCE PUBL LTD
DOI: 10.2174/1567201813666160822104813
Keywords
Acute ischemic stroke; erythropoietin; meta-analysis; randomized controlled trials; recombinant tissue plasminogen activator; systematic review
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Funding
- Suzhou Key Medical Center - National Natural Science Foundation of China [Szzx201501, 81571115, 81422013, 81471196]
- Scientific Department of Jiangsu Province [BL2014045]
- Suzhou Government [LCZX201301, SZS201413, SYS201332]
- Priority Academic Program Development of Jiangsu Higher Education Institutions
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Objective: Erythropoietin (EPO) for treating acute ischemic stroke (AIS) has been investigated in many studies. However, the evidence was inconsistent. Thus, a systematic review and meta-analysis were performed to elucidate the role of EPO in treating patients with AIS. Methods: Two electronic databases (PubMed and EMBASE) were used. 30-day NIHSS measures primary outcome while all-cause mortality in the follow up and 90-day Barthel Index were regarded as secondary outcome. Results are presented as relative risk (RR), standardized mean difference (SMD) and 95% confidence intervals (CI). We employed Stata software to perform the meta-analysis. Results: Four randomized controlled trials (RCTs) involving 784 patients were contained in this meta-analysis. The total combined results on 30-day NIHSS were (SMD = -0.52, 95% CI: -1.39, 0.34) with random-effects model and sensitivity analysis showed a significant difference after excluding the Ehrenreich 2009 trial. The total combined secondary measured results were (RR= 1.72, 95% CI: 1.10, 2.70) and (SMD = 0.01, 95% CI: -0.14, 0.16) for all-cause mortality and 90-day Barthel Index. In the subgroup analysis by using recombinant tissue plasminogen activator (rtPA) earlier, the rtPA group showed increased all-cause mortality with the result of (RR = 1.92, 95% CI: 1.04, 3.52), but not in non-rtPA group. Conclusion: To our systematic review and meta-analysis, we didn't recommend EPO administration for patients with AIS, especially with the combination of rtPA. Large RCTs are warranted to examine EPO efficacy in AIS patients in the future.
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