Tabowei Godfrey, Faiza Rauf Hafiza, Dhungana Milan, Awais Muhammad, Blair Keron, Chaudhari Sandipkumar S, Habib Ihtisham, Amin Adil
Department of Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA.
Medicine, Continental Medical College, Lahore, PAK.
Cureus. 2024 Dec 8;16(12):e75335. doi: 10.7759/cureus.75335. eCollection 2024 Dec.
Colchicine, a long-established anti-inflammatory medication, has emerged as a potential therapeutic agent for secondary prevention of stroke. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of colchicine in preventing secondary stroke by comprehensively synthesizing available evidence. A systematic literature search was conducted across multiple electronic databases from inception to November 15, 2024, using comprehensive search strategies. Randomized controlled trials involving colchicine administration for stroke prevention were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool. Meta-analysis was performed using Review Manager software, with risk ratios calculated for stroke incidence and all-cause mortality. The analysis encompassed seven studies involving 23,303 participants. The meta-analysis revealed a borderline significant 24% relative risk reduction in stroke incidence (risk ratio 0.76, 95% confidence interval 0.57-1.00, p = 0.05). Moderate heterogeneity was observed among studies (I² = 50%). Importantly, no significant difference was found in all-cause mortality between colchicine and control groups (risk ratio 1.03, 95% confidence interval 0.91-1.17, p = 0.66). While the findings suggest potential benefits of colchicine in stroke prevention, the results warrant cautious interpretation. The study emphasizes the need for larger, well-designed randomized controlled trials to definitively establish colchicine's role in comprehensive stroke prevention strategies.
秋水仙碱是一种长期使用的抗炎药物，已成为预防中风二级预防的潜在治疗药物。本系统评价和荟萃分析旨在通过全面综合现有证据来评估秋水仙碱预防继发性中风的疗效和安全性。从数据库建立至2024年11月15日，采用全面的检索策略在多个电子数据库中进行了系统的文献检索。纳入了涉及使用秋水仙碱预防中风的随机对照试验。两名独立的评审员筛选研究、提取数据，并使用Cochrane偏倚风险工具评估方法学质量。使用Review Manager软件进行荟萃分析，计算中风发病率和全因死亡率的风险比。该分析涵盖了7项研究，涉及23,303名参与者。荟萃分析显示中风发病率相对风险降低24%，接近显著水平（风险比0.76，95%置信区间0.57 - 1.00，p = 0.05）。研究间观察到中度异质性（I² = 50%）。重要的是，秋水仙碱组和对照组之间在全因死亡率方面未发现显著差异（风险比1.03，95%置信区间0.91 - 1.17，p = 0.66）。虽然研究结果表明秋水仙碱在预防中风方面有潜在益处，但结果仍需谨慎解读。该研究强调需要进行更大规模、设计良好的随机对照试验，以明确秋水仙碱在全面中风预防策略中的作用。
