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Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

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Τίτλος: Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Συγγραφείς: Hegazi, Amir1 (AUTHOR), Mohamed, Rashad G.1 (AUTHOR), Kashbour, Muataz2 (AUTHOR), Hussien, Hussien O.1 (AUTHOR), Amin, Ahmed Mostafa3 (AUTHOR), Kassar, Omar4 (AUTHOR), Nashwan, Abdulqadir J.5 (AUTHOR), Abouelmagd, Moaz Elsayed6 (AUTHOR)
Πηγή: Medical Principles & Practice. 2026, Vol. 35 Issue 1, p45-61. 17p.
Θεματικοί όροι: *Glibenclamide, *Hemorrhagic stroke, *Randomized controlled trials, *Safety, *Research methodology, *Functional status, *Ischemic stroke, *Cerebral edema
Περίληψη: Objective: This systematic review and meta-analysis aimed to evaluate the clinical and radiological outcomes of glibenclamide versus control in acute stroke. Methods: In accordance with PRISMA guidelines, a comprehensive literature search was conducted to identify relevant studies up to January 15, 2025. Efficacy outcomes included modified Rankin Scale (mRS) score at 3 and 6 months, Barthel index, midline shift at 72–96 h, serum matrix metalloproteinase-9 levels, and decompressive craniectomy. Safety analysis assessed the incidence of hypoglycemia, mortality, and serious adverse events (SAEs). Results: A total of seven randomized controlled trials involving 1,225 patients were included in the meta-analysis. No statistically significant differences were observed in the efficacy outcomes in the pooled analysis. In subgroup analysis of mRS, glibenclamide was superior in intracerebral hemorrhage (mean difference [MD] = −0.67, 95% confidence interval [CI] [−1, −0.34], p value <0.0001) but not ischemic or subarachnoid hemorrhage subtypes (MD = −0.03, 95% CI [−0.34, 0.28], p value = 0.86) and (MD = 0.06, 95% CI [−0.6, 0.71], p value = 0.86), respectively. In terms of safety, there were no significant differences in SAE or mortality (odds ratio [OR] = 1.34, 95% CI [0.99, 1.8], p value = 0.06) and (OR = 0.67, 95% CI [0.31, 1.45], p value = 0.31), respectively. However, glibenclamide was associated with an increased risk of hypoglycemia (OR = 5.03, 95% CI [2.17, 11.66], p value = 0.0002). Conclusion: The use of glibenclamide did not demonstrate improved outcomes in patients with acute stroke. However, real-time pharmacokinetic monitoring, identifying optimal administration route, and patient subgroups, which may potentially benefit from glibenclamide are essential before the drug's efficacy can be conclusively determined. [ABSTRACT FROM AUTHOR]
Βάση Δεδομένων: Academic Search Index
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  Data: Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Medical+Principles+%26+Practice%22&quot;&gt;Medical Principles &amp; Practice&lt;/searchLink&gt;. 2026, Vol. 35 Issue 1, p45-61. 17p.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: This systematic review and meta-analysis aimed to evaluate the clinical and radiological outcomes of glibenclamide versus control in acute stroke. Methods: In accordance with PRISMA guidelines, a comprehensive literature search was conducted to identify relevant studies up to January 15, 2025. Efficacy outcomes included modified Rankin Scale (mRS) score at 3 and 6 months, Barthel index, midline shift at 72–96 h, serum matrix metalloproteinase-9 levels, and decompressive craniectomy. Safety analysis assessed the incidence of hypoglycemia, mortality, and serious adverse events (SAEs). Results: A total of seven randomized controlled trials involving 1,225 patients were included in the meta-analysis. No statistically significant differences were observed in the efficacy outcomes in the pooled analysis. In subgroup analysis of mRS, glibenclamide was superior in intracerebral hemorrhage (mean difference [MD] = −0.67, 95% confidence interval [CI] [−1, −0.34], p value &lt;0.0001) but not ischemic or subarachnoid hemorrhage subtypes (MD = −0.03, 95% CI [−0.34, 0.28], p value = 0.86) and (MD = 0.06, 95% CI [−0.6, 0.71], p value = 0.86), respectively. In terms of safety, there were no significant differences in SAE or mortality (odds ratio [OR] = 1.34, 95% CI [0.99, 1.8], p value = 0.06) and (OR = 0.67, 95% CI [0.31, 1.45], p value = 0.31), respectively. However, glibenclamide was associated with an increased risk of hypoglycemia (OR = 5.03, 95% CI [2.17, 11.66], p value = 0.0002). Conclusion: The use of glibenclamide did not demonstrate improved outcomes in patients with acute stroke. However, real-time pharmacokinetic monitoring, identifying optimal administration route, and patient subgroups, which may potentially benefit from glibenclamide are essential before the drug&#39;s efficacy can be conclusively determined. [ABSTRACT FROM AUTHOR]
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1159/000547648
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      – Code: eng
        Text: English
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        PageCount: 17
        StartPage: 45
    Subjects:
      – SubjectFull: Glibenclamide
        Type: general
      – SubjectFull: Hemorrhagic stroke
        Type: general
      – SubjectFull: Randomized controlled trials
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      – SubjectFull: Safety
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      – SubjectFull: Research methodology
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      – SubjectFull: Functional status
        Type: general
      – SubjectFull: Ischemic stroke
        Type: general
      – SubjectFull: Cerebral edema
        Type: general
    Titles:
      – TitleFull: Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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              Text: 2026
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