A systematic review and meta-analysis of the efficacy of piracetam and piracetam-like compounds in experimental stroke.
OBJECTIVE
Piracetam was a candidate neuroprotective drug for acute stroke ineffective in clinical trial. Here we use systematic review and meta-analysis to describe the evidence supporting a protective effect of piracetam and its derivatives in animal models of stroke.


METHODS
We present a systematic review of reports describing the use of piracetam and its derivatives in animal models of focal ischaemia, where the outcome was measured as an infarct size or neurological score (Der Simonian and Laird random effects meta-analysis).


RESULTS
Only 2 studies, published 10 years after the first clinical trial of piracetam had been initiated, described its efficacy in animal models of stroke. A further 4 studies described the efficacy of related compounds. Piracetam and its derivatives improved the outcome by 30.2% (95% CI = 16.1-44.4). The median study quality was 4/10 (inter-quartile range = 4-6).


CONCLUSIONS
Piracetam and its derivatives demonstrate neuroprotective efficacy in experimental stroke, but our findings raise concerns about the amount of available data, the quality of the studies and publication bias.
Wheble
Philippa C R
PC
Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Sena
Emily S
ES
Macleod
Malcolm R
MR
D000818:Animals; D004195:Disease Models, Animal; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010889:Piracetam / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy*
D018696:Neuroprotective Agents; D010889:Piracetam