Evidence map›Paper›PMID 40268782›Full record

SynthesisEuropean journal of clinical pharmacology2025

Signals from randomized clinical trials predicting hepatotoxicity of flupirtine: systematic review.

Mahir Fidahic, Emilija Lozo Vukovac, Ewa Balkowiec-Iskra, Darko Krnic, Adriana Andric, Zeljana Margan Koletic, Livia Puljak

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Mahir FidahicAgency for Quality and Accreditation in Healthcare in the FBIH, Sarajevo, Bosnia and Herzegovina.ORCID http://orcid.org/0000-0001-6854-6702
Emilija Lozo VukovacDepartment of Pulmonary Diseases, University Hospital Split, Split, Croatia.ORCID http://orcid.org/0000-0001-6271-4103
Ewa Balkowiec-IskraDepartment of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.ORCID http://orcid.org/0000-0001-8882-9769
Darko Krnicpharmaand GmbH, Vienna, Austria.ORCID http://orcid.org/0009-0007-7713-3628
Adriana AndricNDA Regulatory Science Ltd., Leatherhead, UK.ORCID http://orcid.org/0000-0001-5295-1252
Zeljana Margan KoleticThe Department for Pharmacovigilance and Rational Pharmacotherapy, Agency for Medicinal Products and Medical Devices of Croatia (HALMED), Zagreb, Croatia.ORCID http://orcid.org/0000-0001-7855-0748
Livia PuljakCenter for Evidence-Based Medicine and Health Care, Department of Nursing, School of Medicine, Catholic University of Croatia, Ilica 244, 10000, Zagreb, Croatia. livia.puljak@gmail.com.ORCID http://orcid.org/0000-0002-8467-6061

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to systematically review clinical trials evaluating the flupirtine to identify any biochemical or clinical indicators that could signal serious hepatotoxicity.

methodsThis systematic review included randomized controlled trials (RCTs) evaluating flupirtine-containing medicines for any clinical condition. Trials involving any population, comparator, or outcome were considered eligible for inclusion. A comprehensive search was conducted in Embase, MEDLINE, and CENTRAL from their inception until August 14, 2023. The risk of bias (RoB) in the included trials was assessed using Cochrane's 2011 RoB tool. Due to the heterogeneity of the included trials, a meta-analysis could not be performed.

resultsA total of 35 trials published between 1983 and 2022 were included in this systematic review, with 1408 participants receiving flupirtine. Only five trials reported any data related to liver function tests. Among these, four trials documented transient, asymptomatic liver abnormalities that returned to normal after the trial period, while one trial was prematurely terminated. One trial reported normal liver test results in all participants. Of the three trials published after 2018, only one acknowledged the withdrawal of flupirtine from the European market. The majority of risk of bias (RoB) domains were classified as having an unclear risk of bias.

conclusionPublished RCTs did not report any evidence of serious hepatotoxicity associated with flupirtine based on the available biochemical or clinical data. However, liver function test results were reported in only 5 out of 35 included trials. Published RCTs are not reliable information about flupirtine-related hepatotoxicity. REGISTRATION: Protocol was published in PROSPERO (CRD42018085123).

Indexed as

AminopyridinesChemical and Drug Induced Liver InjuryHumansLiver Function TestsRandomized Controlled Trials as TopicAminopyridinesflupirtineFlupirtineHepatotoxicityRandomized clinical trials

Identifiers

What OpenQuestion holds

Textmetadata
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.