The impact of therapy with Mexidol on neurological deficit and functional outcome in patients with ischemic stroke: a systematic review and meta-analysis

Voznyuk I.A.; Kolomentsev S.V.; Morozova E.M.

doi:https://doi.org/10.17116/jnevro202312312249

Voznyuk I.A.

Pavlov First Saint Petersburg State Medical University;
Baltic Center for Neurotechnologies and Artificial Intelligence — Immanuel Kant Baltic Federal University

ORCID: 0000-0002-0340-4110

Kolomentsev S.V.

Baltic Center for Neurotechnologies and Artificial Intelligence — Immanuel Kant Baltic Federal University;
Kirov Military Medical Academy

ORCID: 0000-0002-3756-6214

Morozova E.M.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0002-1395-6234

The impact of therapy with Mexidol on neurological deficit and functional outcome in patients with ischemic stroke: a systematic review and meta-analysis

Authors:

Voznyuk I.A., Kolomentsev S.V., Morozova E.M.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(12‑2): 49‑60

DOI: 10.17116/jnevro202312312249

Read: 3217 times

To cite this article:

Voznyuk IA, Kolomentsev SV, Morozova EM. The impact of therapy with Mexidol on neurological deficit and functional outcome in patients with ischemic stroke: a systematic review and meta-analysis. S.S. Korsakov Journal of Neurology and Psychiatry. 2023;123(12‑2):49‑60. (In Russ., In Engl.)
https://doi.org/10.17116/jnevro202312312249

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски (S.S. Korsakov Journal of Neurology and Psychiatry (special issues))

Использование инфографики авторами научных работ

Close metadata

OBJECTIVE

To evaluate systematically the published peer-reviewed literature and estimate the effect of therapy with Mexidol on the course and outcomes of ischemic stroke (II) in adult patients.

MATERIAL AND METHODS

The meta-analysis included 11 studies reported In Russian (2 randomized controlled studies, 9 non-randomized, unblinded cohort studies).

RESULTS

The results obtained indicate a positive effect of Mexidol on the course of II in the treated adult patients: we found statistically significant decrease in NIHSS scores on days 7—10 and 21—24 and in modified Rankin scale scores on days 5—7 and days 10—14 compared with the control group. The cumulative effect of the drug was shown: the between-group difference of the NIHSS scores increases with the course of observation time. The effect of Mexidol on indicators on the NIHSS scale is more significant, the greater the initial severity of the patient’s neurological deficit.

CONCLUSION

Heterogeneity in study designs and patient characteristics has resulted in significant statistical heterogeneity, and the evidence presented at the time of writing requires further examination as new data become available.

Keywords:

ischemic stroke

neuroprotection

Mexidol

ethylmethylhydroxypyridine succinate

meta-analysis

NIHSS scale

modified Rankin scale

cerebrovascular diseases

Authors:

Voznyuk I.A.

Pavlov First Saint Petersburg State Medical University;
Baltic Center for Neurotechnologies and Artificial Intelligence — Immanuel Kant Baltic Federal University

ORCID: 0000-0002-0340-4110

Kolomentsev S.V.

Baltic Center for Neurotechnologies and Artificial Intelligence — Immanuel Kant Baltic Federal University;
Kirov Military Medical Academy

ORCID: 0000-0002-3756-6214

Morozova E.M.

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0002-1395-6234

Received:

17.11.2023

Accepted:

17.11.2023

Close metadata

References:

Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J. 2021;6(1):I-LXII.
Aguiar De Sousa D, Wilkie A, Norrving B, et al. Delivery of acute ischaemic stroke treatments in the European region in 2019 and 2020. Eur Stroke J. 2023;8:618-628.
Omelyanovsky VV, Avksentyeva MV, Sura MV, et al. Guidelines for conducting meta-analysis: FGBU «CECCMP»; 2017. (In Russ.).
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Med. 2021;18(3):e1003583.
Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ. 2008;336(56):1049-1054.
Rumyantseva SA, Evseev VN, Eliseev EV. Antioxidant therapy for acute ischemic stroke. Atmosphere. Nervous diseases. 2009;3:8-12. (In Russ.).
Loskutnikov MA, Domashenko MA, Vakin TM, et al. The trial of the efficacy and safety of sequential therapy with Mexidol forte 250 in acute and early recovery stages of hemispheric ischemic stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2020;120(10):22-26. (In Russ.). https://doi.org/10.17116/jnevro202012010122
Chefranova ZhYu, Makotrova TA, Udachin VA, Koledintseva EV. Efficacy of mexidol in the combination with thrombolytic therapy in patients with ischemic stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2012;112(4):49-52. (In Russ.).
Abramenko YuV. Effect of mexidol on lipid-phospholipid profile changes in elderly patients with stroke. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(2):68-75. (In Russ.). https://doi.org/10.14412/2074-2711-2018-2-68-75
Kulai NS, Kovalchuk EYu. Assessment of the efficacy of mexidol in the combination with hyperbaric oxygen in acute ischemic stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2018;118(3-2):69-72. (In Russ.). https://doi.org/10.17116/jnevro20181183269-72
Lutskiĭ MA. An analysis of mexidol efficacy in the complex treatment of patients with ischemic stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2010;110(4-2):57-59. (In Russ.).
Knni KS, Dyomin TV, Adeeva LB. Effect of mexidol on the efficiency of intravenous thrombolytic therapy for ischemic stroke during the therapeutic window. Neurology, Neuropsychiatry, Psychosomatics. 2018;10(3):86-90. (In Russ.). https://doi.org/10.14412/2074-2711-2018-3-86-90
Plotnikov DM, Stegmeier MN, Aliev OI. Evaluation of blood rheology by patients with acute ischemic stroke with Mexidol administration. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2019;119(3-2):76-82. (In Russ.). https://doi.org/10.17116/jnevro201911903276
Stakhovskaya LV, Mkhitaryan EA, Tkacheva ON, et al. Efficacy and safety of mexidol across age groups in the acute and early recovery stages of hemispheric ischemic stroke (results of additional sub-analysis of a randomized double blind multicenter placebo-controlled study, in parallel groups trial EPICA). Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2020;120(8-2):49-57. (In Russ.). https://doi.org/10.17116/jnevro202012008249
Stakhovskaya LV, Shamalov NA, Khasanova DR, et al. Results of a randomized double blind multicenter placebo-controlled, in parallel groups trial of the efficacy and safety of prolonged sequential therapy with mexidol in the acute and early recovery stages of hemispheric ischemic stroke (EPICA). Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2017;117(3-2):55-65. (In Russ.). https://doi.org/10.17116/jnevro20171173255-65
Stakhovskaya LV, Tyutyumova EA, Fedin AI. Modern approaches to neuroprotective treatment of ischemic stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2017;117(8-2):75-80. (In Russ.). https://doi.org/10.17116/jnevro20171178275-80
Strel’nikova IA, Svetkina AA, Androfagina OV. The efficacy and safety of Mexidol Forte 250 as part of long-term sequential therapy in patients with carotid stroke. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova. 2020;120(3-2):54-58. (In Russ.). https://doi.org/10.17116/jnevro202012003254
Skvortsova VI, Stakhovskaya LV, Nartsyssov YaR, et al. The randomized double-blind placebo-controlled study of efficacy and safety of mexidol in the complex therapy of ischemic stroke in the acute period. Insult. 2006;18:47-54. (In Russ.).