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

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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:

S.V. Kolomentsev

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

ORCID: 0000-0002-3756-6214

E.M. Morozova

Pavlov First Saint Petersburg State Medical University

ORCID: 0000-0002-1395-6234

Received:

17.11.2023

Accepted:

17.11.2023

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