Safety and efficacy of edaravone in patients with amyotrophic lateral sclerosis: a systematic review and meta-analysis

• Published in: Neurological sciences Vol. 44; no. 10; pp. 3429 - 3442
• Main Authors: Nourelden, Anas Zakarya, Kamal, Ibrahim, Hagrass, Abdulrahman Ibrahim, Tawfik, Abdelrahman G., Elhady, Mahmoud M., Fathallah, Ahmed Hashem, Eshag, Mona Muhe Eldeen, Zaazouee, Mohamed Sayed
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2023; Springer Nature B.V
• Subjects: Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - chemically induced; Amyotrophic Lateral Sclerosis - drug therapy; Clinical trials; Edaravone - therapeutic use; Humans; Medicine; Medicine & Public Health; Meta-analysis; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Patients; Prospective Studies; Psychiatry; Quality of Life; Review; Review Article; Safety; Severity of Illness Index; Side effects; Survival; Systematic review; United States; United States; ALS; Amyotrophic lateral sclerosis; Edaravone; Meta-analysis
• ISSN: 1590-1874; 1590-3478; 1590-3478
• DOI: 10.1007/s10072-023-06869-8

Aim The study aims to increase understanding of edaravone’s efficacy and safety as an amyotrophic lateral sclerosis (ALS) treatment and provide significant insights regarding this field’s future research. Methods We conducted a comprehensive search of the Embase, PubMed, Cochrane Library, Web of Science, and Scopus databases for randomized controlled trials and observational studies up until September 2022. We evaluated the studies’ quality using the Cochrane risk of bias tool and the National Institutes of Health tool. Results We included 11 studies with 2845 ALS patients. We found that edaravone improved the survival rate at 18, 24, and 30 months (risk ratio (RR) = 1.03, 95% confidence interval (CI) [1.02 to 1.24], P  = 0.02), (RR = 1.22, 95% CI [1.06 to 1.41], P  = 0.007), and (RR = 1.17, 95% CI [1.01 to 1.34], P  = 0.03), respectively. However, the administration of edaravone did not result in any significant difference in adverse effects or efficacy outcomes between the two groups, as indicated by a P value greater than 0.05. Conclusion Edaravone improves survival rates of ALS patients at 18, 24, and 30 months with no adverse effects. However, edaravone does not affect functional outcomes. In order to ensure the validity of our findings and assess the results in accordance with the disease stage, it is essential to carry out additional prospective, rigorous, and high-quality clinical trials. The current study offers preliminary indications regarding the effectiveness and safety of edaravone. However, further comprehensive research is required to establish the generalizability and sustainability of the findings.