The effect of therapy with the drug Mexol on the regression of neurological deficiency and a functional outcome in patients with ischemic stroke: a systematic review and meta analysis

Authors:
I.A. VOZNYUK^1,2, S.V. KOLOMETSEV^2,3, E.M. MOROZOVA¹

¹First Saint Petersburg State Medical University named after I.P. Pavlov, Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia;
²Baltic Center for Neurotechnology and Artificial Intelligence, Immanuel Kant Baltic Federal University, Kaliningrad, Russia;
³Kirov Military Medical Academy, Ministry of Defense of the Russian Federation, Saint Petersburg, Russia

Place of publication:
S.S. KORSAKOV JOURNAL OF NEUROLOGY AND PSYCHIATRY, 2023, Vol. 123, No. 12, Issue 2

Abstract:
The aim of the study was to systematically evaluate data published in peer-reviewed journals on the effects of Mexidol therapy on the course and outcomes of ischemic stroke (IS) in adult patients.

Material and methods. The meta-analysis included 11 studies published in Russian (2 randomized controlled trials, 9 non-randomized unblinded cohort studies).

Results. Data demonstrated a positive effect of Mexidol on the course of ischemic stroke in adult patients: statistically significant reductions in NIHSS scores on days 7-10 and 21-24, and modified Rankin Scale scores on days 5-7 and 10-14, compared with the comparison group. A cumulative effect of the drug was demonstrated: the difference in NIHSS scores increased with the duration of observation. The effect of Mexidol on NIHSS scores was more significant with the greater the initial severity of neurological deficit.

Conclusion. Heterogeneity in study designs and patient characteristics resulted in significant statistical heterogeneity, and therefore the evidence available at the time of writing requires further study in light of emerging data.

Key words: ischemic stroke, neuroprotection, Mexidol, ethylmethylhydroxypyridine succinate, meta-analysis, NIHSS scale, modified Rankin scale, cerebrovascular diseases.