Evidence map›Paper›PMID 38403671›Full record

SynthesisNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2024

Effectiveness and safety of mexiletine versus placebo in patients with myotonia: a systematic review and meta-analysis.

Abdelrahman Mohammed Elettreby, Ahmed Abdullah Abo Elnaga, Mohamed Ahmed Alsaied, Dalia Kamal Ewis, Aya Mohammed Sharkawy, Rahma Fareed, Gehad Magdy Alderbi

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Treatment updates in myotonic disorders.Journal of neurology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Abdelrahman Mohammed ElettrebyFaculty of Medicine, Mansoura University, El Gomhouria St, Mansoura, 35511, Egypt. Am731784@gmail.com.ORCID http://orcid.org/0009-0003-3283-7219
Ahmed Abdullah Abo ElnagaFaculty of Medicine, Mansoura University, El Gomhouria St, Mansoura, 35511, Egypt.
Mohamed Ahmed AlsaiedFaculty of Medicine, Mansoura University, El Gomhouria St, Mansoura, 35511, Egypt.
Dalia Kamal EwisMedical Research Group of Egypt, Negida Academy LLC, Arlington, MA, 02474, USA.
Aya Mohammed SharkawyMedical Research Group of Egypt, Negida Academy LLC, Arlington, MA, 02474, USA.
Rahma FareedMedical Research Group of Egypt, Negida Academy LLC, Arlington, MA, 02474, USA.
Gehad Magdy AlderbiMedical Research Group of Egypt, Negida Academy LLC, Arlington, MA, 02474, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe rare nature of dystrophic and non-dystrophic myotonia has limited the available evidence on the efficacy of mexiletine as a potential treatment. To address this gap, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of mexiletine for both dystrophic and non-dystrophic myotonic patients.

methodsThe search was conducted on various electronic databases up to March 2023, for randomized clinical trials (RCTs) comparing mexiletine versus placebo in myotonic patients. A risk of bias assessment was carried out, and relevant data was extracted manually into an online sheet. RevMan software (version 5.4) was employed for analysis.

resultsA total of five studies, comprising 186 patients, were included in the meta-analysis. Our findings showed that mexiletine was significantly more effective than placebo in improving stiffness score (SMD =  - 1.19, 95% CI [- 1.53, - 0.85]), as well as in reducing hand grip myotonia (MD =  - 1.36 s, 95% CI [- 1.83, - 0.89]). Mexiletine also significantly improved SF-36 Physical and Mental Component Score in patients with non-dystrophic myotonia only. Regarding safety, mexiletine did not significantly alter ECG parameters but was associated with greater gastrointestinal symptoms (GIT) compared to placebo (RR 3.7, 95% CI [1.79, 7.64]). Other adverse events showed no significant differences.

conclusionThe results support that mexiletine is effective and safe in myotonic patients; however, it is associated with a higher risk of GIT symptoms. Due to the scarcity of published RCTs and the prevalence of GIT symptoms, we recommend further well-designed RCTs testing various drug combinations to reduce GIT symptoms.

Indexed as

MexiletineMyotoniaHumansRandomized Controlled Trials as TopicTreatment OutcomeVoltage-Gated Sodium Channel BlockersMexiletineVoltage-Gated Sodium Channel BlockersDystrophic myotoniaMexiletineNon-dystrophic myotoniaStiffness

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.