Meta-analysis of defibrase in treatment of acute cerebral infarction.
BACKGROUND
Fibrinogen-depleting agents are promising in the treatment of cerebral ischemic disease. They were studied by many trials, and the outcomes were different because of different regimens and different doses. In this study, we assessed the efficacy and safety of defibrase on acute cerebral infarction in China.


METHODS
A search using Chinese hospital knowledge database (CHKD) and MEDLINE database for randomized controlled trials was carried out. A CHKD (1994 June 2005) search was performed with the keyword "defibrase", then a second search for the keyword "acute cerebral infarction"; a MEDLINE search (1950 June 2005) was performed with the following keywords: [(cerebral ischemia), OR (acute cerebral infarction), OR (stroke)], AND [defibrase]. Meta-analysis was performed with RevMan software 4.2.


RESULTS
Included were 14 studies comparing the efficiency and safety of defibrase with other drugs in the treatment of acute cerebral infarction. Patients' records were pooled (total 646 patients; defibrase, n = 328, no defibrase n = 318). Neurological deficit score (NDS) before treatment showed weighted mean differences (WMD) = 0.95, 95% confidence interval (CI) = (-0.60, 2.50), P = 0.23; NDS after treatment showed WMD = -2.20, 95% CI = (-4.21, -0.18), P = 0.03; Barthel index at 3 months showed WMD = 4.45, 95% CI = (-0.13, 9.03), P = 0.06; the plasma fibrinogen level before treatment showed WMD = 0.02, 95% CI = (-0.16, 0.19), P = 0.86; plasma fibrinogen level after treatment showed WMD = -1.51, 95% CI = (-1.88, -1.15), P < 0.00 001.


CONCLUSIONS
With the given dose and regimen of defibrase in China, defibrase may play a role of anticoagulation. It might inhibit the progression of stroke and prevent the recurrence of stroke.
Guo
Yi
Y
Department of Neurology, Second Affiliated Hospital of Jinan University, Shenzhen 518020, China. yi_g4326@yahoo.com.cn
Zuo
Yan-fang
YF
Wang
Qi-zhang
QZ
Tang
Bing-shan
BS
Li
Fu-kang
FK
Sun
Yi
Y
D000208:Acute Disease; D000328:Adult; D000368:Aged; D012103:Batroxobin / Q000627:therapeutic use*; D002544:Cerebral Infarction / Q000097:blood / Q000188:drug therapy*; D005340:Fibrinogen / Q000032:analysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged
D005343:Fibrinolytic Agents; D005340:Fibrinogen; D012103:Batroxobin