Scholarlink

Objective <p>This systematic review and meta-analysis aimed to evaluate the safety and efficacy of intravenous (IV) nerinetide in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) without prior or concurrent IV thrombolysis (IVT).</p> Methods <p>A systematic search of PubMed, Web of Science, and Scopus was conducted through March 15, 2025, identifying randomized controlled trials (RCTs) comparing EVT plus nerinetide versus EVT plus placebo without IVT. Screening and data extraction were performed independently by two reviewers, with conflicts resolved by a third. Risk of bias was assessed using RoB 2.0. Data were synthesized using RevMan 5.4 with random-effects models, and heterogeneity was evaluated via chi-square and I<sup>2</sup> statistics.</p> Results <p>Three RCTs comprising 726 patients in the IV nerinetide group and 668 in the placebo group were included. Nerinetide did not significantly improve functional outcomes: 90-day modified Rankin Scale (mRS) 0–1 (RR: 1.02, 95% CI: [0.71, 1.47], <i>P = </i>0.92) and mRS 0–2 (RR: 1.07, 95% CI: [0.93, 1.22], <i>P = </i>0.35). No significant differences were observed in 90-day mortality (RR: 0.89, 95% CI: [0.60, 1.34], <i>P = </i>0.59) or adverse events, including symptomatic intracranial hemorrhage (RR: 0.80, 95% CI: [0.44, 1.45], <i>P = </i>0.46).</p> Conclusion <p>Nerinetide administration during EVT in AIS patients without IVT did not significantly improve functional independence, survival, or safety outcomes compared to placebo. Although preclinical data supported neuroprotection, clinical benefits were not observed, highlighting the challenges in translating neuroprotective strategies into effective stroke therapies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy and safety of intravenous nerinetide in acute ischemic stroke patients undergoing endovascular thrombectomy without thrombolysis: a meta-analysis of randomized controlled trials

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月16日

查看全文
  • Abdallah Abbas,
  • Haneen Sabet,
  • Sherief Ghozy,
  • Basant Lashin

摘要

Objective

This systematic review and meta-analysis aimed to evaluate the safety and efficacy of intravenous (IV) nerinetide in acute ischemic stroke (AIS) patients undergoing endovascular thrombectomy (EVT) without prior or concurrent IV thrombolysis (IVT).

Methods

A systematic search of PubMed, Web of Science, and Scopus was conducted through March 15, 2025, identifying randomized controlled trials (RCTs) comparing EVT plus nerinetide versus EVT plus placebo without IVT. Screening and data extraction were performed independently by two reviewers, with conflicts resolved by a third. Risk of bias was assessed using RoB 2.0. Data were synthesized using RevMan 5.4 with random-effects models, and heterogeneity was evaluated via chi-square and I2 statistics.

Results

Three RCTs comprising 726 patients in the IV nerinetide group and 668 in the placebo group were included. Nerinetide did not significantly improve functional outcomes: 90-day modified Rankin Scale (mRS) 0–1 (RR: 1.02, 95% CI: [0.71, 1.47], P = 0.92) and mRS 0–2 (RR: 1.07, 95% CI: [0.93, 1.22], P = 0.35). No significant differences were observed in 90-day mortality (RR: 0.89, 95% CI: [0.60, 1.34], P = 0.59) or adverse events, including symptomatic intracranial hemorrhage (RR: 0.80, 95% CI: [0.44, 1.45], P = 0.46).

Conclusion

Nerinetide administration during EVT in AIS patients without IVT did not significantly improve functional independence, survival, or safety outcomes compared to placebo. Although preclinical data supported neuroprotection, clinical benefits were not observed, highlighting the challenges in translating neuroprotective strategies into effective stroke therapies.