title: Edaravone for acute ischaemic stroke.
abstract: BACKGROUND
  Neuroprotection is a promising therapeutic strategy for the treatment of acute ischaemic stroke. Edaravone is a neuroprotective agent that has been widely used in China, and several studies have suggested that it may be beneficial in acute ischaemic stroke.
  
  
  OBJECTIVE
  To assess the efficacy and safety of edaravone for acute ischaemic stroke.
  
  
  METHODS
  We searched the Cochrane Stroke Group Trials Register (November 2010) and the Chinese Stroke Trials Register (November 2010). In addition, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 4), MEDLINE (1950 to November 2010), EMBASE (1980 to November 2010), China National Knowledge Infrastructure (1979 to November 2010), Chinese Biomedical Database (1979 to November 2010), Chinese Evidence-Based Medicine Database (November 2010) and Chinese Science and Technology Journals Database (1980 to November 2010). In an attempt to identify further published, unpublished and ongoing trials we searched reference lists and clinical trials and research registers, and contacted a pharmaceutical company, researchers and study authors.
  
  
  METHODS
  We included randomised controlled trials comparing edaravone with placebo or no intervention in patients with acute ischaemic stroke.
  
  
  METHODS
  Two review authors selected trials for inclusion, assessed trial quality and independently extracted the data.
  
  
  RESULTS
  We included three trials, involving 496 participants, and defined four trials as waiting assessment. All three included trials were of edaravone plus another treatment compared with the other treatment alone. The dose of edaravone injections in the three trials was the same at 60 mg per day. The course of treatment in all three trials is 14 days. None of the included trials reported the pre-specified primary outcome of death or dependency defined using the modified Rankin scale during the follow-up period. The three trials evaluated the effect of edaravone at different times and using different methods. All three trials reported adverse events; there were no differences between the treatment group and the control group. Overall, edaravone appeared to increase the proportion of participants with marked neurological improvement compared with the control group, and the difference was significant (risk ratio (RR) 1.99, 95% confidence interval (CI) 1.60 to 2.49).
  
  
  CONCLUSIONS
  The risk of bias in the included trials was moderate and the sample was small. Hence, although the data in this review show an effective treatment trend of edaravone for acute ischaemic stroke, further large, high-quality trials are required to confirm this trend.
authors.affiliation: (a) Department of Neurology, West China Hospital, Sichuan University, Chengdu, China, (b) Second Department of Neurology, Central Hospital, Handan, China.
authors.forename: Shejun
authors.initials: S
authors.lastname: Feng
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Yang
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Weizheng
authors.initials: W
authors.lastname: Li
authors.forename: Wenming
authors.initials: W
authors.lastname: Yuan
authors.forename: Shihong
authors.initials: S
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.forename: Juntao
authors.initials: J
authors.lastname: Li
mesh_terms: D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002545:Brain Ischemia / Q000150:complications; D000077553:Edaravone; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology
chemical_list: D016166:Free Radical Scavengers; D018696:Neuroprotective Agents; D000077553:Edaravone; D000983:Antipyrine