title: Efficacy and safety of therapies for acute ischemic stroke in China: a network meta-analysis of 13289 patients from 145 randomized controlled trials.
abstract: BACKGROUND
  Many of these therapies have been compared against placebos, but have not been directly compared against each other. To evaluate the efficacy and safety of several commonly used drugs for AIS directly or indirectly.
  
  
  METHODS
  A systematic literature review was performed to identify randomized controlled trials (RCTs) published prior to April 2013 for AIS therapies. The primary outcome measures were the National Institutes of Health Stroke Scale (NIHSS) scores and the clinical effective rate. A fixed-effects meta-analysis and meta-regression are performed; lastly, performed a mixed treatment comparison was performed through the Bayesian methods.
  
  
  RESULTS
  Outcome of efficacy of therapies for acute ischemic stroke are as followed: All of the therapies mentioned above yielded results a more effective result than placebo, Sodium ozagrel (RR 3.86, 95%CI 3.18-4.61); Sodium ozagrel + edaravone (RR 9.60, 95%CI 7.04-13.06); Edaravone (RR 4.07, 95%CI 3.30-5.01); Edaravone + Kininogenase (RR 15.33, 95%CI 10.03-23.05). The significant difference in efficacy between edaravone monotherapy and Sodium ozagrel + edaravone was evident (RR 0.43, 95%CI 0.08-0.61) and was also significant between efficacy of edaravone + Kininogenase and Sodium ozagrel (RR 4.00, 95%CI 2.47-6.24). The differences between the risk and benefit were not significant when comparing Sodium ozagrel and edaravone or edaravone + Kininogenase and Sodium ozagrel + Edaravone for AIS. Outcome of the defect of neurological function: Placebo served a significant difference in treating the defects of neurological function compared with Sodium ozagrel (WMD = -3.11, 95%CI -4.43 to -1.79), Sodium ozagrel + edaravone (WMD = -6.25, 95%CI -7.96 to -4.54) and Edaravone + Kininogenase (WMD =  -3.47, 95%CI -5.73 to -1.21).
  
  
  CONCLUSIONS
  It provides that the efficacy of edaravone monotherapy in treatment was not more effective than Sodium ozagrel + edaravone.The efficacy of edaravone + Kininogenase monotherapy in treatment was more effective than Sodium ozagrel. Edaravone + Kininogenase and Sodium ozagrel + Edaravone appeared the most effective treatments. And Sodium ozagrel, Sodium ozagrel + edaravone, Edaravone + Kininogenase can improve the nerve dysfunction.
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Bowen
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Jingpu
authors.initials: J
authors.lastname: Shi
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Ma
authors.affiliation: Department of Clinical Epidemiology, Institute of Cardiovascular Diseases and Center of Evidence Based Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Sun
mesh_terms: D000368:Aged; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001499:Bayes Theorem; D002681:China; D003029:Coagulants / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000077553:Edaravone; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007610:Kallikreins / Q000627:therapeutic use*; D008689:Methacrylates / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D003029:Coagulants; D005343:Fibrinolytic Agents; D016166:Free Radical Scavengers; D008689:Methacrylates; D007610:Kallikreins; C034364:ozagrel; D000077553:Edaravone; D000983:Antipyrine