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Published in: Neurological Sciences 2/2019

01-02-2019 | Review Article

Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis

Authors: Linting Luo, Zhibin Song, Xiaoqiang Li, Huiwang, Yaqing Zeng, Qinwang, Meiqi, Jianli He

Published in: Neurological Sciences | Issue 2/2019

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Abstract

Background

Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.

Methods

We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the I2 statistic.

Results

A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00, P = .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19, P = .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19, P = .20) were found.

Conclusion

Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.

Clinical trial registration

The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191; http://​www.​crd.​york.​ac.​uk/​PROSPERO.)
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Metadata
Title
Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis
Authors
Linting Luo
Zhibin Song
Xiaoqiang Li
Huiwang
Yaqing Zeng
Qinwang
Meiqi
Jianli He
Publication date
01-02-2019
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 2/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-018-3653-2

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