Evidence map›Paper›PMID 38356890›Full record

SynthesisFrontiers in neurology2024

A systematic-search-and-review of registered pharmacological therapies investigated to improve neuro-recovery after a stroke.

Tsong-Hai Lee, Shinichiro Uchiyama, Yohanna Kusuma, Hou Chang Chiu, Jose C Navarro, Kay Sin Tan, Jeyaraj Pandian, Liang Guo, Yoko Wong, Narayanaswamy Venketasubramanian and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Article
  7. Review
  8. Current neuroprotective agents in stroke.Turkish journal of physical medicine and rehabilitation · 2024
    Review
  9. Stroke: Perspectives from Asia.Cerebrovascular diseases extra · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Tsong-Hai LeeLinkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Shinichiro UchiyamaClinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Medical Center, Tokyo, Japan.
Yohanna KusumaNational Brain Center Hospital, Jakarta, Indonesia.
Hou Chang ChiuTaipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
Jose C NavarroJose R. Reyes Memorial Medical Center, Manila, Philippines.
Kay Sin TanUniversity of Malaya Medical Center, Kuala Lumpur, Malaysia.
Jeyaraj PandianChristian Medical College and Hospital, Ludhiana, India.
Liang GuoSingapore Clinical Research Institute, Consortium for Clinical Research and Innovation, Singapore, Singapore.
Yoko Wong *Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation, Singapore, Singapore.
Narayanaswamy VenketasubramanianRaffles Hospital, Singapore, Singapore.
Asian Stroke Advisory Panel

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Stroke burden is largely due to long-term impairments requiring prolonged care with loss of productivity. We aimed to identify and assess studies of different registered pharmacological therapies as treatments to improve post-stroke impairments and/or disabilities. Methods: We performed a systematic-search-and-review of treatments that have been investigated as recovery-enhancing or recovery-promoting therapies in adult patients with stroke. The treatment must have received registration or market authorization in any country regardless of primary indication. Outcomes included in the review were neurological impairments and functional/disability assessments. "The best available studies" based on study design, study size, and/or date of publication were selected and graded for level of evidence (LOE) by consensus. Results: Our systematic search yielded 7,801 citations, and we reviewed 665 full-text papers. Fifty-eight publications were selected as "the best studies" across 25 pharmacological classes: 31 on ischemic stroke, 21 on ischemic or hemorrhagic stroke, 4 on intracerebral hemorrhage, and 2 on subarachnoid hemorrhage (SAH). Twenty-six were systematic reviews/meta-analyses, 29 were randomized clinical trials (RCTs), and three were cohort studies. Only nimodipine for SAH had LOE A of benefit (systematic review and network meta-analysis). Many studies, some of which showed treatment effects, were assessed as LOE C-LD, mainly due to small sample sizes or poor quality. Seven interventions had LOE B-R (systematic review/meta-analysis or RCT) of treatment effects. Conclusion: Only one commercially available treatment has LOE A for routine use in stroke. Further studies of putative neuroprotective drugs as adjunctive treatment to revascularization procedures and more confirmatory trials on recovery-promoting therapies will enhance the certainty of their benefit. The decision on their use must be guided by the clinical profile, neurological impairments, and target outcomes based on the available evidence. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=376973, PROSPERO, CRD42022376973.

Indexed as

evidenceneuro-restorationrecoveryrehabilitationreviewstroke

Identifiers

PMID38356890
PMCPMC10866005

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.