Published online Dec 28, 2021. doi: 10.13105/wjma.v9.i6.585
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
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.
The evidence-based of efficacy and safety evaluation of fingolimod in stroke patients is currently unavailable.
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.
In this study, we performed a systemic review and meta-analysis of recent randomized controlled trials to confirm the above hypothesis.
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.
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.
More high-quality randomized controlled studies involving more patients are needed to provide more clinical research evidence.