Efficacy and safety of anisodine hydrobromide injection for acute ischemic stroke: a systematic review and meta-analysis

Yang Wang; Feng Wan; Peiqun Hu; Benxiang He; Yushi Hu; Yunlu Liu

doi:10.3389/fphar.2023.1290755

Efficacy and safety of anisodine hydrobromide injection for acute ischemic stroke: a systematic review and meta-analysis

Front Pharmacol. 2023 Nov 15:14:1290755. doi: 10.3389/fphar.2023.1290755. eCollection 2023.

Authors

Yang Wang^#^{1

2}, Feng Wan^#³, Peiqun Hu¹, Benxiang He⁴, Yushi Hu¹, Yunlu Liu⁵

Affiliations

¹ School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China.
² Postdoctoral Workstation, Affiliated Sport Hospital of Chengdu Sport University, Chengdu, Sichuan, China.
³ State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
⁴ Sichuan Academy of Chinese Medicine Science, Chengdu, Sichuan, China.
⁵ Institute of Laboratory Animal Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.

^# Contributed equally.

Abstract

Background: Acute ischemic stroke (AIS) is a leading cause of death and disability worldwide. This study aimed to evaluate the efficacy and safety of anisodine hydrobromide (Ani) injection in the treatment of AIS. Methods: Randomized controlled trials (RCTs) based on Ani injection for the treatment of AIS were retrieved from both Chinese and English databases. The retrieval period was from the databases' inception to May 2023. The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality. The outcome indicators were analyzed using RevMan 5.3 software. Results: We included the findings of 11 RCTs encompassing 1,337 patients with AIS. Our meta-analysis revealed that Ani injection supplementation significantly reduced the National Institutes of Health Stroke Scale [MD = -1.53, 95%CI = (-1.94, -1.12), p < 0.00001], modified Rankin Scale [MD = -0.89, 95%CI = (-0.97, -0.81), p < 0.00001], and the relative time to peak [SMD = -0.81, 95%CI = (-1.08, -0.55), p < 0.00001] significantly. Additionally, Ani injection significantly increased the Barthel Index [MD = 10.65, 95%CI = (4.30, 17.00), p = 0.001], relative cerebral blood volume [SMD = 0.28, 95%CI = (0.02, 0.53), p = 0.03], and clinical efficacy [RR = 1.2, 95%CI = (1.08, 1.34), p = 0.001]. No statistically significant difference in the rate of adverse events was observed between the Ani injection supplemental group and the control group. Conclusion: Based on currently published evidence, Ani injection was found to be effective and safe in improving AIS outcome. Nevertheless, limitations of the included RCTs still exist, and thus, more multi-center, large-sample, high-quality RCTs are required to further verify the efficacy and safety of Ani injection in patients with AIS. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023427591], identifier [PROSPERO 2023 CRD42023427591].

Keywords: acute ischemic stroke; anisodine hydrobromide injection; efficacy; meta-analysis; systematic review.

Publication types

Systematic Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Sichuan Province (No. 2022NSFSC1529), S&T Project of Sichuan Provincial Administration of Traditional Chinese Medicine (No. 2021MS519), and the Fund of Key Laboratory for Sports Medicine of Sichuan Province and General Administration of Sport (No. 2023-A032).