Zhao K, Guo Y, Yang MF, Zhang Q. Efficacy and safety of fingolimod in stroke: A systemic review and meta-analysis. World J Meta-Anal 2021; 9(6): 585-597 [DOI: 10.13105/wjma.v9.i6.585]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Dec 28, 2021; 9(6): 585-597 Published online Dec 28, 2021. doi: 10.13105/wjma.v9.i6.585
Efficacy and safety of fingolimod in stroke: A systemic review and meta-analysis
Kai Zhao, Yu Guo, Ming-Fei Yang, Qiang Zhang
Kai Zhao, Yu Guo, Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
Ming-Fei Yang, Qiang Zhang, Department of Neurosurgery, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
Author contributions: Zhang Q and Zhao K conceived the idea and designed the study; Zhao K and Guo Y screened the studies and extracted the data independently; Yang MF and Guo Y analysed and interpreted the data; Zhao K and Guo Y wrote the first draft of the manuscript; Zhang Q proofread the manuscript before submission; all authors reviewed the manuscript and approved the final version.
Supported bythe National Key R&D Program of China, No. 2018YFC1312601; and the Project of Science and Technology Department of Qinghai Province, No. 2020-ZJ-774.
Conflict-of-interest statement: On behalf of all authors, the corresponding author states that there is no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: August 18, 2021 Peer-review started: August 18, 2021 First decision: November 2, 2021 Revised: November 13, 2021 Accepted: December 24, 2021 Article in press: December 24, 2021 Published online: December 28, 2021 Processing time: 132 Days and 4.6 Hours
ARTICLE HIGHLIGHTS
Research background
Brain tissue injury in stroke patients involves inflammation around the infarction lesion or hematoma, which is an important reason for disease deterioration and can result in a poor prognosis. The meta-analysis of animal experiments has concluded that fingolimod could treat stroke in animal models by effectively reducing lymphocyte infiltration.
Research motivation
The evidence-based of efficacy and safety evaluation of fingolimod in stroke patients is currently unavailable.
Research objectives
We hypothesized that fingolimod could effectively and safely promote reduction of infarction lesion or hematoma and improve neurological prognosis in AIS or ICH patients by reducing lymphocyte infiltration.
Research methods
In this study, we performed a systemic review and meta-analysis of recent randomized controlled trials to confirm the above hypothesis.
Research results
There was a significant difference in CD8+ T cell count and modified Barthel index between the fingolimod and control groups. However, there was no significant difference in lesion volume, fever, suspected lung infection (pooled RR = 0.90, 95%CI: 0.33-2.43, P = 0.876), and all adverse events occurring at least once between the fingolimod and control groups.
Research conclusions
Fingolimod might improve neurological function in stroke patients by reducing lymphocyte infiltration in the brain effectively. Fingolimod might not promote infarction lesion or hematoma absorption. Oral fingolimod (0.5 mg/d, 3 consecutive days) is safe in stroke patients except for some rare severe adverse events.
Research perspectives
More high-quality randomized controlled studies involving more patients are needed to provide more clinical research evidence.
