SynthesisNeurocritical care2025
The Efficacy and Safety of Glibenclamide in Improving Cerebral Edema and Neurological Outcomes in Stroke: a GRADE-Evaluated Systematic Review and Meta-analysis with Subgroup Analysis.
Synthesis in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStroke is a significant cause of morbidity and mortality worldwide, with cerebral edema being a major complication. Glibenclamide, a SUR1-TRPM4 channel inhibitor, has been proposed to reduce cerebral edema, but its clinical efficacy remains uncertain. This meta-analysis aimed to evaluate the efficacy and safety of glibenclamide in patients with stroke, including acute ischemic stroke, acute subarachnoid hemorrhage, and intracerebral hemorrhage.
methodsA comprehensive literature search was conducted in PubMed, Web of Science, and Scopus up to January 2025. The primary efficacy outcomes included excellent (modified Rankin Scale [mRS] score 0-1) and good (mRS score 0-2) functional outcomes at 90 days. Safety outcomes included the incidence of hypoglycemia and decompressive craniectomy. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
resultsTen and eight randomized controlled trials (RCTs) were included in our qualitative and quantitative analysis, respectively, encompassing 1,691 participants aged 18 to 85. No significant difference was observed between the glibenclamide and control groups regarding excellent functional outcome (risk ratio [RR] 1.10, 95% confidence interval [CI] 0.92-1.32, P = 0.29) and good functional outcome (RR 1.07, 95% CI 0.96-1.18, P = 0.22). Safety analysis revealed no significant increase in serious adverse events (RR 1.11, 95% CI 1.00-1.23, P = 0.06). Notably, hypoglycemia incidence after sensitivity analysis was higher in the glibenclamide group (RR 4.56, 95% CI 2.07-10.03, P = 0.0002).
conclusionsGlibenclamide did not significantly improve functional outcomes or reduce mortality in stroke patients but was associated with a higher incidence of hypoglycemia. Further well-designed RCTs are needed to clarify its therapeutic role and optimize safety protocols. CLINICAL
trial registrationPROSPERO registration number: CRD420251008350.
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