The Landscape of Randomized Clinical Trial Meta-analyses on Statins for Aneurysmal Subarachnoid Hemorrhage: A Scoping Review

Author:

Skouras Panagiotis1ORCID,Kalamatianos Theodosis1,Markouli Mariam2,Karagiannis Angelos3,Stavrinou Lampis C.4

Affiliation:

1. 1st Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Greece

2. Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA

3. Department of Cardiology, Emory University, Atlanta, GA 30322, USA

4. 2nd Department of Neurosurgery, Attiko Hospital, National and Kapodistrian University of Athens, Greece

Abstract

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) is a type of non-traumatic SAH that can have detrimental effects on the central nervous system, resulting in severe disability or death. Methods: Early nimodipine is currently the only strongly recommended pharmacological treatment that has shown efficacy in improving neurological/functional outcomes in aSAH patients. Whether statin treatment is of benefit to aSAH patients is an issue that has generated considerable interest and debate. In the present scoping review, we mapped and analyzed the available literature on metaanalyses of randomized clinical trials (RCTs) examining the effect of statins on aSAH. Seventeen meta-analyses of RCTs, published between 2008 and 2023, were identified. Results: Treatments in included meta-analyses were based on various regimens of simvastatin, pravastatin, pitavastatin or atorvastatin for up to 21 days. Eleven of the included reports indicated some beneficial effect of statin treatment, reducing rates of at least one of the following: cerebral vasospasm, delayed cerebral ischemia/delayed ischemic neurologic deficit, mortality or functional/ neurological outcome. In contrast, six meta-analyses, showed no such effects. Conclusion: The limitations reported by several meta-analyses, included low patient numbers or disproportionate representation of patients from certain RCTs, differences in drug treatment, patient diagnostic criteria and outcome evaluation between RCTs, as well as poor data quality or lack of RCTs data. Knowledge of the reported limitations may aid the design of future clinical trials and/or their meta-analyses.

Publisher

Bentham Science Publishers Ltd.

Subject

Pharmacology,General Neuroscience

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Subarachnoid Hemorrhage;CNS & Neurological Disorders - Drug Targets;2024-11

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