Wheble Philippa C R, Sena Emily S, Macleod Malcolm R
Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
Cerebrovasc Dis. 2008;25(1-2):5-11. doi: 10.1159/000111493. Epub 2007 Nov 22.
BACKGROUND/OBJECTIVE: Piracetam was a candidate neuroprotective drug for acute stroke ineffective in clinical trial. Here we use systematic review and meta-analysis to describe the evidence supporting a protective effect of piracetam and its derivatives in animal models of stroke.
We present a systematic review of reports describing the use of piracetam and its derivatives in animal models of focal ischaemia, where the outcome was measured as an infarct size or neurological score (Der Simonian and Laird random effects meta-analysis).
Only 2 studies, published 10 years after the first clinical trial of piracetam had been initiated, described its efficacy in animal models of stroke. A further 4 studies described the efficacy of related compounds. Piracetam and its derivatives improved the outcome by 30.2% (95% CI = 16.1-44.4). The median study quality was 4/10 (inter-quartile range = 4-6).
Piracetam and its derivatives demonstrate neuroprotective efficacy in experimental stroke, but our findings raise concerns about the amount of available data, the quality of the studies and publication bias.
背景/目的：吡拉西坦曾是一种用于急性中风的神经保护候选药物，但在临床试验中无效。在此，我们采用系统评价和荟萃分析来描述支持吡拉西坦及其衍生物在中风动物模型中具有保护作用的证据。
我们对描述吡拉西坦及其衍生物在局灶性缺血动物模型中的应用的报告进行了系统评价，其中结局指标为梗死面积或神经学评分（Der Simonian和Laird随机效应荟萃分析）。
仅2项研究（在吡拉西坦首次临床试验开始10年后发表）描述了其在中风动物模型中的疗效。另外4项研究描述了相关化合物的疗效。吡拉西坦及其衍生物使结局改善了30.2%（95%CI=16.1-44.4）。研究质量中位数为4/10（四分位间距=4-6）。
吡拉西坦及其衍生物在实验性中风中显示出神经保护疗效，但我们的研究结果引发了对可用数据量、研究质量和发表偏倚的担忧。
