Cerebrolysin for acute ischaemic stroke

Abstract

The findings of this Cochrane Review do not demonstrate clinical benefits of cerebrolysin for treating acute ischaemic stroke. We found moderate-quality evidence of an increase in non-fatal SAEs with cerebrolysin use but not in total SAEs.

Randomized, placebo-controlled, double-blind, pilot trial to investigate safety and efficacy of Cerebrolysin in patients with aneurysmal subarachnoid hemorrhage

“…To date five meta-analyses of RCTs investigating the efficacy of Cerebrolysin in acute ischemic stroke have been performed [ 38 – 42 ]. Three, evaluating aggregate data from up to seven trials involving 1501 to 1779 patients, concluded that the medication did not demonstrate any clinical benefit [ 38 , 41 , 42 ].…”

“…To date five meta-analyses of RCTs investigating the efficacy of Cerebrolysin in acute ischemic stroke have been performed [ 38 – 42 ]. Three, evaluating aggregate data from up to seven trials involving 1501 to 1779 patients, concluded that the medication did not demonstrate any clinical benefit [ 38 , 41 , 42 ]. In particular, a Cochrane Review did not find Cerebrolysin to be useful, but several trials were excluded from the analysis since treatment initiation exceeded the review protocol’s prespecified 48-h stroke-onset window [ 38 ].…”

“…Randomized placebo-controlled clinical trials (RCT) evaluating the role of Cerebrolysin in acute ischemic stroke patients have demonstrated improved 90-day functional outcomes with regard to motor performance, the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS) and the Barthel Index (BI) [ 32 – 37 ]. Although several meta-analyses have been performed, the role of Cerebrolysin in acute ischemic stroke has yet to be defined [ 38 – 42 ]. A recent study, analyzing nine RCTs, revealed encouraging results by observing improved three-month mRS and NIHSS outcomes when early treatment was initiated within 72 h of stroke [ 40 ].…”

Hope Dies Last—Evidence Again Fails to Support a Neuroprotectant

“…8 One recent Cochrane review based on 6 trials evaluates the effects of cerebrolysin in acute ischemic stroke and concludes that the use of cerebrolysin has no effect on fatality. 9,10 Five of the included trials were small, and in the largest trial, the comparison groups were not balanced for prognostic factors. The loss to follow-up was considerable in the trials.…”

“…Despite the lack of evidence from systematic reviews for efficacy regarding both fatality 9 and functional outcome, 14 cerebrolysin has been used in several countries, with limited healthcare resources in Asia and Eastern Europe. Although subgroup-and post hoc analyses suggested potential benefit of cerebrolysin, these claims should be currently considered only hypotheses.…”