Sodium Ozagrel Combined with Edaravone for Cerebral Infarction: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHU Xiaoying ¹ , QIU Youbo ² ,  YANG Zheng ³

1. Department of Obstetrics & Gynaecology, the First Affiliated Hospital, Chengdu Medical College, Chengdu 610500, China;2. Clinical Medicine College, Chengdu Medical College, Chengdu 610081, China;3. Department of Experimental Technology, Chengdu Medical College, Chengdu 610081, China;

Corresponding author：

YANG Zheng, Email: yz3191021@yahoo.com.cn

Keywords：

Sodium ozagrel; Edaravone; Cerebral infarction; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20110156

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess the effectiveness and safety of sodium ozagrel combined with edaravone for cerebral infarction.
Methods 　Such databases as PubMed (1995 to 2010), EMCC (1995 to 2010), CBM (1995 to 2010), CNKI (1995 to 2010), and VIP (1989 to 2010) were searched to collect randomized controlled trials (RCTs) of odium ozagrel combined with edaravone for cerebral infarction. Then the retrieved studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality of the included studies was evaluated, and meta-analyses were performed by using the Cochrane Collaboration’s RevMan 5.0 software.
Results 　A total of 32 RCTs involving 3 059 cases were involved, among which 1 559 cases were in the treatment group and the other 1500 were in the control group. All studies with comparable baseline data reported the application of random methods without explaining the detailed methods, the blinding method and the allocation concealment. The results of meta-analyses indicated that sodium ozagrel combined with edaravone had significant differences in the effective rate for cerebral infarction compared with both single sodium ozagrel (OR=3.51, 95%CI 2.70 to 4.57) and routine treatment (OR=3.77, 95%CI 2.58 to 5.52), and it had significant differences in treating the defect of neurological function compared with both sodium ozagrel (WMD= –4.26, 95%CI –4.97 to –3.55) and routine treatment (WMD= –3.89, 95%CI –4.96 to –2.82). In addition, Sodium ozagrel combined with edaravone was superior to sodium ozagrel (WMD=13.57, 95%CI 9.84 to 17.30) in improving the ability of daily living.
Conclusion 　This systematic review shows that sodium ozagrel combined with edaravone is quite effective in treating cerebral infarction, and it can improve the nerve dysfunction. This conclusion should be treated cautiously for the poor quality and higher possibility of bias in the included studies which may impact on the power of proof, so more double-blind RCTs with high quality are expected to provide high-quality evidence.

Citation： ZHU Xiaoying,QIU Youbo,YANG Zheng. Sodium Ozagrel Combined with Edaravone for Cerebral Infarction: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(8): 932-939. doi: 10.7507/1672-2531.20110156 Copy

1.	1 Felberg RA, Burgin WS, Grotta JC. Neurop rotection and the ischemic cascade. C-NS Spectrums , 2005, 10(5): 52-58.
2.	Tanaka M. Pharmacological and clinical profile of the free radical scavenger edaravone as a neuroprotective agent. Nippon Yakurigaku Zasshi , 2002, 119(5): 301-308.
3.	Takabatake Y, Uno E, Wakamatsu K, et al . The clinical effect of combination therapy with edaravone and sodi- um ozagrel for acute cerebral infarction. No To Shinkei , 2003, 55(7): 589-593.
4.	全国第四届脑血管病学术会议. 脑卒中患者临床神经功能缺损程度评分标准(1995). 中华神经科杂志, 1996, 29(6): 381.
5.	Jadad AR, Moore RA, Carroll D, et al . Assessing the quality of reports of randomized clinical trials: is blinding necessary. Control Clin Trials , 1996, 17(1): 1-12.
6.	周立春, 贾伟华, 安春华, 等. 奥扎格雷钠联合依达拉奉治疗急性脑梗死的临床疗效及安全性. 中国卒中杂志, 2006, 1(9): 624-626.
7.	王舒健. 依达拉奉联合奥扎格雷钠治疗急性脑梗死30例疗效观察. 中国实用医药, 2008, 3, (28): 116-117.
8.	范可好, 肖立成. 依达拉奉联合奥扎格雷钠治疗急性脑梗死40例. 医学理论与实践, 2008, 21(12): 1404-1405.
9.	邓智建, 曹冬梅, 周国胜. 依达拉奉联合奥扎格雷钠治疗急性脑梗死42例. 中国医药导, 2008, 5(6): 11-12.
10.	屈新华. 依达拉奉联合奥扎格雷钠治疗急性脑梗死90例. 中国现代医生, 2009, 47(26): 71, 111.
11.	马连顺, 马永杰. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国实用神经疾病杂志, 2009, 12(5): 45-46.
12.	朱廷彦, 贾军, 王永超. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国现代药物应用, 2009, 3(20): 128-129.
13.	陈达, 窦文波, 刘艳. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效观察. 山西医药杂志, 2006, 35(11): 1027-1028.
14.	李炳选, 崔岩, 林燕, 等. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效观察. 药学与临床研究, 2008, 16(5): 378-380.
15.	李大光, 陈英华, 孙兴华. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效评价. 中国医疗前沿, 2009, 4(17): 59.
16.	陈志强. 依达拉奉联合奥扎格雷钠治疗急性脑梗死临床疗效观察. 疑难病杂志, 2008, 7(7): 416-417.
17.	李守社. 依达拉奉联合奥扎格雷钠治疗进展性脑梗死临床研究. 中国实用神经疾病杂志, 2008, 11(11): 9-11.
18.	吴莉娟. 依达拉奉联合奥扎格雷钠治疗脑梗死临床研究. 中国实用神经疾病杂志, 2009, 12(13): 51-52.
19.	黄海涛. 依达拉奉联合奥扎格雷治疗急性脑梗死的效果观察. 交通医学, 2008, 22(5): 495-496.
20.	陈远芳, 王一玲, 辛琳琳. 依达拉奉与奥扎格雷钠联合治疗急性脑梗死疗效观察. 吉林医药学院学报, 2008, 29(3): 130-131.
21.	窦志红. 依达拉奉治疗急性进展型脑梗死的疗效观察. 新乡医学院学报, 2008, 25(5): 503-504.
22.	闻绍云. 依达拉奉治疗急性脑梗死的疗效观察. 现代实用医学, 2006, 18(11): 787.
23.	白玉春, 王巍巍, 白日壮. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死60例临床分析. 中国煤炭工业医学杂志, 2009, 12 (1): 44-45.
24.	李爱霞, 孔令振, 李洁. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的临床评价. 临床医学, 2009, 29(11): 18-20.
25.	郭建华, 朱涛. 奥扎格雷钠与依达拉奉联合治疗急性脑梗死(附48例疗效观察). 航空航天医药, 2009, 20(12): 5-6.
26.	吴昌贵, 苏光华, 庄珩. 依达拉奉联合奥扎格雷钠治疗脑梗死82例临床观察. 实用临床医学, 2009, 10(7): 36-37.
27.	徐晓华, 周怀力, 周武. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国实用医药, 2009, 4(l1): 166-167.
28.	王兴文. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 广东医学, 2009, 30(1l): 1739-1740.
29.	潘雪芳. 依达拉奉联合奥扎格雷钠治疗脑梗死疗效观察. 中国现代药物应用, 2008, 2(19): 44.
30.	袁峰. 奥扎格雷钠联合依达拉奉治疗急性脑梗死. 山东医学高等专科学校学报, 2009, 31(5): 374-376.
31.	王清, 郭永, 姜超. 奥扎格雷钠联合依达拉奉治疗急性脑梗死疗效观察. 汕头大学医学院学报, 2009, 22(3): 141-142, 155.
32.	周国平, 李丹. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死的疗效观察. 当代医学, 2009, 15(27): 91-92.
33.	胡秋兰. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死临床观察. 基层医学论坛, 2009, 13(20): 618-619.
34.	杨春茂, 李德正, 袁锐三. 依达拉奉联合奥扎格雷钠治疗急性脑梗死66例疗效观察. 山东医药, 2008, 48(21): 60.
35.	王五洲, 李爱丽, 王艳婷. 奥扎格雷钠和依达拉奉联合治疗急性脑梗死疗效观察. 中国实用神经疾病杂志, 2008, 11(6): 70-71.
36.	颜敏, 李翠华. 依达拉奉和奥扎格雷钠治疗脑梗死临床观察. 中华现代内科学杂志, 2008, 5(1): 52-53.
37.	毕惠珍. 依达拉奉针联合奥扎格雷钠针治疗急性脑梗死的疗效观察. 当代医学, 2009, 15(27): 147-148.
38.	Adama HP Jr, Adama RJ, Brott T, et al . Guidelines for the early management of patients with ischemic stroke. Stroke , 2003, 34 (4): 1056-1083.
39.	Imamura T, Kiguchi S, Kobayashi K, et al . Effect of ozagre, la selective thromboxane 7 A2-synthetase inhibitor, on cerebral infarct- ttion in rats. Comparative study with norp-henazone, a free-radical scavenger. Arznei- mittelfors-chung , 2003, 53(10): 688-694.
40.	Tanahashi N. Antit hrombotic therapy in cerebral infarction. Rinsho Shinkeigaku , 2000, 40(12): 1251.
41.	Edaraven Acute Infarction Study Group. Effect of a novel free radical scavenger edaravone (MCI-186), on acute brain inarction. Randomized placebo-controlled double-blind study atmulticenters. Cerebrovasc Dis , 2003, 15: 222.
42.	Peters O, Back T, Lindauer U, et al . Increased formation of reactive oxygen species after permanent and reversible middle cerebral artery occlusion in the rat. J Cereb Blood Flow Metab , 1998, 18(2): 196-205.
43.	Shishidu T, Suzuki R, Qian L, et al . The role of superoxide anion in the pat hogenesis of cerebral vasospasm. Stroke , 1994, 25, (4): 864-868.
44.	Zhang N, Kom ine-Kobayashi M, Tanaka R, et al . Edaravone reduces early accumulation of oxidative products and sequential inflammatory responese after transient focal ischemia in mice brain. Stroke , 2005, 36(10): 2220-2225.

1. 1 Felberg RA, Burgin WS, Grotta JC. Neurop rotection and the ischemic cascade. C-NS Spectrums , 2005, 10(5): 52-58.
2. Tanaka M. Pharmacological and clinical profile of the free radical scavenger edaravone as a neuroprotective agent. Nippon Yakurigaku Zasshi , 2002, 119(5): 301-308.
3. Takabatake Y, Uno E, Wakamatsu K, et al . The clinical effect of combination therapy with edaravone and sodi- um ozagrel for acute cerebral infarction. No To Shinkei , 2003, 55(7): 589-593.
4. 全国第四届脑血管病学术会议. 脑卒中患者临床神经功能缺损程度评分标准(1995). 中华神经科杂志, 1996, 29(6): 381.
5. Jadad AR, Moore RA, Carroll D, et al . Assessing the quality of reports of randomized clinical trials: is blinding necessary. Control Clin Trials , 1996, 17(1): 1-12.
6. 周立春, 贾伟华, 安春华, 等. 奥扎格雷钠联合依达拉奉治疗急性脑梗死的临床疗效及安全性. 中国卒中杂志, 2006, 1(9): 624-626.
7. 王舒健. 依达拉奉联合奥扎格雷钠治疗急性脑梗死30例疗效观察. 中国实用医药, 2008, 3, (28): 116-117.
8. 范可好, 肖立成. 依达拉奉联合奥扎格雷钠治疗急性脑梗死40例. 医学理论与实践, 2008, 21(12): 1404-1405.
9. 邓智建, 曹冬梅, 周国胜. 依达拉奉联合奥扎格雷钠治疗急性脑梗死42例. 中国医药导, 2008, 5(6): 11-12.
10. 屈新华. 依达拉奉联合奥扎格雷钠治疗急性脑梗死90例. 中国现代医生, 2009, 47(26): 71, 111.
11. 马连顺, 马永杰. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国实用神经疾病杂志, 2009, 12(5): 45-46.
12. 朱廷彦, 贾军, 王永超. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国现代药物应用, 2009, 3(20): 128-129.
13. 陈达, 窦文波, 刘艳. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效观察. 山西医药杂志, 2006, 35(11): 1027-1028.
14. 李炳选, 崔岩, 林燕, 等. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效观察. 药学与临床研究, 2008, 16(5): 378-380.
15. 李大光, 陈英华, 孙兴华. 依达拉奉联合奥扎格雷钠治疗急性脑梗死疗效评价. 中国医疗前沿, 2009, 4(17): 59.
16. 陈志强. 依达拉奉联合奥扎格雷钠治疗急性脑梗死临床疗效观察. 疑难病杂志, 2008, 7(7): 416-417.
17. 李守社. 依达拉奉联合奥扎格雷钠治疗进展性脑梗死临床研究. 中国实用神经疾病杂志, 2008, 11(11): 9-11.
18. 吴莉娟. 依达拉奉联合奥扎格雷钠治疗脑梗死临床研究. 中国实用神经疾病杂志, 2009, 12(13): 51-52.
19. 黄海涛. 依达拉奉联合奥扎格雷治疗急性脑梗死的效果观察. 交通医学, 2008, 22(5): 495-496.
20. 陈远芳, 王一玲, 辛琳琳. 依达拉奉与奥扎格雷钠联合治疗急性脑梗死疗效观察. 吉林医药学院学报, 2008, 29(3): 130-131.
21. 窦志红. 依达拉奉治疗急性进展型脑梗死的疗效观察. 新乡医学院学报, 2008, 25(5): 503-504.
22. 闻绍云. 依达拉奉治疗急性脑梗死的疗效观察. 现代实用医学, 2006, 18(11): 787.
23. 白玉春, 王巍巍, 白日壮. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死60例临床分析. 中国煤炭工业医学杂志, 2009, 12 (1): 44-45.
24. 李爱霞, 孔令振, 李洁. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的临床评价. 临床医学, 2009, 29(11): 18-20.
25. 郭建华, 朱涛. 奥扎格雷钠与依达拉奉联合治疗急性脑梗死(附48例疗效观察). 航空航天医药, 2009, 20(12): 5-6.
26. 吴昌贵, 苏光华, 庄珩. 依达拉奉联合奥扎格雷钠治疗脑梗死82例临床观察. 实用临床医学, 2009, 10(7): 36-37.
27. 徐晓华, 周怀力, 周武. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 中国实用医药, 2009, 4(l1): 166-167.
28. 王兴文. 依达拉奉联合奥扎格雷钠治疗急性脑梗死的疗效观察. 广东医学, 2009, 30(1l): 1739-1740.
29. 潘雪芳. 依达拉奉联合奥扎格雷钠治疗脑梗死疗效观察. 中国现代药物应用, 2008, 2(19): 44.
30. 袁峰. 奥扎格雷钠联合依达拉奉治疗急性脑梗死. 山东医学高等专科学校学报, 2009, 31(5): 374-376.
31. 王清, 郭永, 姜超. 奥扎格雷钠联合依达拉奉治疗急性脑梗死疗效观察. 汕头大学医学院学报, 2009, 22(3): 141-142, 155.
32. 周国平, 李丹. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死的疗效观察. 当代医学, 2009, 15(27): 91-92.
33. 胡秋兰. 奥扎格雷钠联合依达拉奉治疗进展性脑梗死临床观察. 基层医学论坛, 2009, 13(20): 618-619.
34. 杨春茂, 李德正, 袁锐三. 依达拉奉联合奥扎格雷钠治疗急性脑梗死66例疗效观察. 山东医药, 2008, 48(21): 60.
35. 王五洲, 李爱丽, 王艳婷. 奥扎格雷钠和依达拉奉联合治疗急性脑梗死疗效观察. 中国实用神经疾病杂志, 2008, 11(6): 70-71.
36. 颜敏, 李翠华. 依达拉奉和奥扎格雷钠治疗脑梗死临床观察. 中华现代内科学杂志, 2008, 5(1): 52-53.
37. 毕惠珍. 依达拉奉针联合奥扎格雷钠针治疗急性脑梗死的疗效观察. 当代医学, 2009, 15(27): 147-148.
38. Adama HP Jr, Adama RJ, Brott T, et al . Guidelines for the early management of patients with ischemic stroke. Stroke , 2003, 34 (4): 1056-1083.
39. Imamura T, Kiguchi S, Kobayashi K, et al . Effect of ozagre, la selective thromboxane 7 A2-synthetase inhibitor, on cerebral infarct- ttion in rats. Comparative study with norp-henazone, a free-radical scavenger. Arznei- mittelfors-chung , 2003, 53(10): 688-694.
40. Tanahashi N. Antit hrombotic therapy in cerebral infarction. Rinsho Shinkeigaku , 2000, 40(12): 1251.
41. Edaraven Acute Infarction Study Group. Effect of a novel free radical scavenger edaravone (MCI-186), on acute brain inarction. Randomized placebo-controlled double-blind study atmulticenters. Cerebrovasc Dis , 2003, 15: 222.
42. Peters O, Back T, Lindauer U, et al . Increased formation of reactive oxygen species after permanent and reversible middle cerebral artery occlusion in the rat. J Cereb Blood Flow Metab , 1998, 18(2): 196-205.
43. Shishidu T, Suzuki R, Qian L, et al . The role of superoxide anion in the pat hogenesis of cerebral vasospasm. Stroke , 1994, 25, (4): 864-868.
44. Zhang N, Kom ine-Kobayashi M, Tanaka R, et al . Edaravone reduces early accumulation of oxidative products and sequential inflammatory responese after transient focal ischemia in mice brain. Stroke , 2005, 36(10): 2220-2225.

Chinese Journal of Evidence-Based Medicine

Sodium Ozagrel Combined with Edaravone for Cerebral Infarction: A Systematic Review

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