title: Efficacy and safety of MLC601 (NeuroAiD®), a traditional Chinese medicine, in poststroke recovery: a systematic review.
abstract: BACKGROUND
  Subsequent to a pooled analysis of 2 trials, several more studies have been published assessing the benefit of MLC601 in stroke patients. Hence, it is timely to conduct an updated meta-analysis to frame the interpretation of the results of an ongoing large multicenter, randomized, double-blind, placebo-controlled study. Therefore, we conducted a systematic review of the efficacy of MLC601 in improving the recovery of stroke patients.
  
  
  METHODS
  PubMed® and the Cochrane Library® databases were searched for trials evaluating MLC601 in stroke patients. Primary outcome was functional independence, assessed by the Barthel Index or the Diagnostic Therapeutic Effects of Apoplexy scoring system, item 8. Secondary outcomes were improvement in functional independence scores, motor recovery, reduction in visual field defect and increase in cerebral blood flow. Two authors performed the article selection, appraisal and data extraction while resolving differences through discussion or consulting a third author. Data were analyzed in RevMan5®. Meta-analysis was conducted using a random effects model.
  
  
  RESULTS
  This review included 6 studies with overall low risk of bias but some clinical heterogeneity. MLC601 increased the chances of achieving functional independence after stroke compared to control treatments (risk ratio, 2.35; 95% CI, 1.31-4.23). No deaths and 4 serious adverse events were reported in the MLC601 group, although detail was sparse with inconsistent reporting.
  
  
  CONCLUSIONS
  There is evidence that MLC601 as an add-on to standard treatment could be effective in improving functional independence and motor recovery and is safe for patients with primarily nonacute stable stroke.
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Fahad Javaid
authors.initials: FJ
authors.lastname: Siddiqui
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Venketasubramanian
authors.forename: Edwin Shih-Yen
authors.initials: ES
authors.lastname: Chan
authors.forename: Christopher
authors.initials: C
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000187:drug effects / Q000502:physiology; D009068:Movement / Q000502:physiology; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function / Q000187:drug effects*; D020521:Stroke / Q000188:drug therapy*; D013534:Survival; D016896:Treatment Outcome; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal; C546417:Neuroaid; D018696:Neuroprotective Agents