Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Tirilazad mesylate in acute ischemic stroke - A systematic review
Autore:
Bath, PMW; Blecic, S; Bogousslavsky, J; Boysen, G; Davis, S; Diez-Tejedor, E; Ferro, JM; Gommans, J; Hacke, W; Indredavik, B; Norrving, B; Orgogozo, JM; Ringelstein, EB; Sacchetti, ML; Idddenden, R; Bath, FJ; Musch, BC; Brosse, DM; Naberhuis-Stehouwer, SA;
Indirizzi:
Univ Nottingham, Div Stroke Med, Nottingham NG5 1PB, England Univ Nottingham Nottingham England NG5 1PB , Nottingham NG5 1PB, England Free Univ Brussels, Erasme Hosp, B-1050 Brussels, Belgium Free Univ Brussels Brussels Belgium B-1050 osp, B-1050 Brussels, Belgium CHU Vaudois, CH-1011 Lausanne, Switzerland CHU Vaudois Lausanne Switzerland CH-1011 , CH-1011 Lausanne, Switzerland Univ Copenhagen, Hvidovre Hosp, DK-2650 Hvidovre, Denmark Univ CopenhagenHvidovre Denmark DK-2650 Hosp, DK-2650 Hvidovre, Denmark Royal Melbourne Hosp, Melbourne, Vic, Australia Royal Melbourne Hosp Melbourne Vic Australia , Melbourne, Vic, Australia Hosp La Paz, Madrid, Spain Hosp La Paz Madrid SpainHosp La Paz, Madrid, Spain Hosp St Maria, Lisbon, Portugal Hosp St Maria Lisbon PortugalHosp St Maria, Lisbon, Portugal Hawkes Bay Hosp, Hastings, New Zealand Hawkes Bay Hosp Hastings New Zealand es Bay Hosp, Hastings, New Zealand Univ Klinikum Heidelberg, Heidelberg, Germany Univ Klinikum Heidelberg Heidelberg Germany elberg, Heidelberg, Germany Tondheims Sykehus, Trondheim, Norway Tondheims Sykehus Trondheim NorwayTondheims Sykehus, Trondheim, Norway Univ Sjukhuset, Lund, Sweden Univ Sjukhuset Lund SwedenUniv Sjukhuset, Lund, Sweden Hop Pellegrin, F-33076 Bordeaux, France Hop Pellegrin Bordeaux France F-33076 ellegrin, F-33076 Bordeaux, France Univ Munster, D-4400 Munster, Germany Univ Munster Munster Germany D-4400 niv Munster, D-4400 Munster, Germany Univ La Sapienza, Rome, Italy Univ La Sapienza Rome ItalyUniv La Sapienza, Rome, Italy Pharmacia & Upjohn Inc, Kalamazoo, MI 49001 USA Pharmacia & Upjohn Inc Kalamazoo MI USA 49001 nc, Kalamazoo, MI 49001 USA
Titolo Testata:
STROKE
fascicolo: 9, volume: 31, anno: 2000,
pagine: 2257 - 2265
SICI:
0039-2499(200009)31:9<2257:TMIAIS>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIGH-DOSE TIRILAZAD; ANEURYSMAL SUBARACHNOID HEMORRHAGE; PEROXIDATION INHIBITOR U74006F; RANDOMIZED CONTROLLED TRIAL; FREE-RADICAL SCAVENGER; CEREBRAL BLOOD-FLOW; DOUBLE-BLIND; PLASMINOGEN-ACTIVATOR; THROMBOLYTIC THERAPY; FOREBRAIN ISCHEMIA;
Keywords:
cerebral infarction; meta-analysis; neuroprotective agents; treatment outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
63
Recensione:
Indirizzi per estratti:
Indirizzo: Bath, PMW Univ Nottingham, Div Stroke Med, City Hosp Campus, Nottingham NG5 1PB, England Univ Nottingham City Hosp Campus Nottingham England NG5 1PBand
Citazione:
P.M.W. Bath et al., "Tirilazad mesylate in acute ischemic stroke - A systematic review", STROKE, 31(9), 2000, pp. 2257-2265

Abstract

Background and Purpose-Tirilazad is a nonglucocorticoid, 21-aminosteroid that inhibits lipid peroxidation. Studies in experimental models of ischemicstroke had suggested that tirilazad had neuroprotective properties. As a result, clinical studies were undertaken to assess the safety and efficacy of tirilazad in the treatment of acute ischemic stroke. We performed a systematic review of randomized, controlled trials that assessed the safety and efficacy of tirilazad in patients with acute ischemic stroke. Methods-Trials of tirilazad were identified from searches of the Cochrane Library and communication with the Pharmacia & Upjohn company, the manufacturer of tirilazad. Data relating to early and end-of-trial case fatality, disability (Barthel Index and Glasgow Outcome Scale), phlebitis, and corrected QT interval were extracted by treatment group from published data and company reports and analyzed by using the Cochrane Collaboration meta-analysis software REVMAN. Results-Six trials (4 published, 2 unpublished) assessing tirilazad in 1757 patients with presumed acute ischemic stroke were identified; ail were double-blind and placebo controlled in design. Tirilazad did not alter early case fatality (odds ratio [OR] 1.11, 95% confidence interval [CI] 0.79 to 1.56) or end-of-trial case fatality (OR 1.12, 95% CI 0.88 to 1.44). A just-significant increase in death and disability, assessed as either the expanded Barthel Index (OR 1.23, 95% CI 1.01 to 1.51) or Glasgow Outcome Scale (OR1.23, 95% CI 1.01 to 1.50) was observed. Tirilazad significantly increasedthe rate of infusion site phlebitis (OR 2.81, 95% CI 2.14 to 3.69). Functional outcome (expanded Barthel Index) was significantly worse in prespecified subgroups of patients: females (OR 1.46, 95% CI 1.08 to 1.98) and subjects receiving low-dose tirilazad (OR 1.31, 95% CI 1.03 to 1.67); a nonsignificant worse outcome was also seen in patients with mild to moderate stroke (OR 1.40, 95% CI 0.99 to 1.98). Conclusions-Tirilazad mesylate increases death and disability by about onefifth when given to patients with acute ischemic stroke. Although further trials of tirilazad are now unwarranted, analysis of individual patient data from the trials may help elucidate why tirilazad appears to worsen outcome in acute ischemic stroke.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/01/21 alle ore 01:19:00