Evidence map›Paper›PMID 40629227›Full record

SynthesisActa neurologica Belgica2026

Neuroprotective effect of Glibenclamide in stroke: a systematic review and meta-analysis of randomized controlled trials.

Guilherme José da Costa Borsatto, Heitor Pereira Vale da Costa, Laís Silva Santana, Mauri Brandão de Medeiros Neto, Victor Zanetti Strutz, Pedro Henrique Mouty Rabello, Vitor Nagai Yamaki, João Paulo Mota Telles, Eberval Gadelha Figueiredo

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Acta neurologica Belgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Guilherme José da Costa BorsattoSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil. guilherme.borsatto@fm.usp.br.ORCID http://orcid.org/0000-0002-7145-0063
Heitor Pereira Vale da CostaSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil.
Laís Silva SantanaSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil.
Mauri Brandão de Medeiros NetoSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil.
Victor Zanetti StrutzSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil.
Pedro Henrique Mouty RabelloSchool of Medicine, University of Sao Paulo, São Paulo, São Paulo, Brazil.
Vitor Nagai YamakiDivision of Neurological Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
João Paulo Mota TellesDepartment of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Eberval Gadelha FigueiredoDepartment of Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundStroke is a leading cause of death and disability, with cerebral edema contributing to poor outcomes. Glibenclamide, a sulfonylurea with potential neuroprotective properties, has shown effect in reducing cerebral edema in preclinical studies. This meta-analysis aimed to evaluate its efficacy in functional outcomes, cerebral edema, and mortality in patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (aSH).

methodsA systematic review and meta-analysis of randomized controlled trials (RCTs) comparing Glibenclamide to standard care in the acute management of stroke was conducted. Outcomes included functional status (mRS 0-3 at 3 months), cerebral edema (midline shift at 72-96 h), mortality, and hypoglycemia events.

resultsSeven RCTs involving 1,225 patients met inclusion criteria. Glibenclamide did not improve functional status at 3 months in AIS and aSH but showed modest functional benefits in ICH (RR = 1.16; 95% CI: 1.04-1.28). No significant reduction in cerebral edema was observed in AIS (mean difference = 1.36 mm; 95% CI: -4.21 to 1.48). Mortality rates remained unchanged at discharge in aSH (RR = 0.78; 95% CI: 0.41-1.48) or at 3 months in AIS (RR = 0.97; 95% CI: 0.53-1.79). However, Glibenclamide increased hypoglycemia risk (RR = 3.57; 95% CI: 1.19-10.68).

conclusionThis meta-analysis found no significant benefits in functional outcomes, cerebral edema, or mortality with Glibenclamide in acute stroke. Despite an increased hypoglycemia risk, encouraging results in individual trials suggest potential benefits in specific subgroups. Further research should focus on identifying these subpopulations to refine Glibenclamide's role as a neuroprotective therapy.

Indexed as

GlyburideNeuroprotective AgentsRandomized Controlled Trials as TopicStrokeBrain EdemaHumansHypoglycemic AgentsGlyburideHypoglycemic AgentsNeuroprotective AgentsCerebral edemaGlibenclamideMeta-analysisStrokeSulfonylureaSystematic review

Identifiers

PMID40629227

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.