Issue 2-84, 2018

Meta-Analysis: Semax Effectiveness in the Acute Period of Stroke

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1,2 Shmonin A.A., 1 Verbickaya E.V., 2 Soloveva L.N., 1 Malceva M.N., 1,2 Melnikova E.V.

1 GBOU VPO First Saint-Petersburg I.P. Pavlov State Medical University, Saint-Petersburg, Russia
2 SbP GBUZ Saint-Petersburg City Hospital №26, Saint-Petersburg, Russia


ABSTRACT

Background: Despite the scientific interest to neuroprotectors, the current evidence base is insufficient.The aim of the study was to evaluate the effectiveness of Semax in the acute period of stroke in the meta-analysis ofRussian literature.Materials and methods: A systematic search was performed across 3 databases of studies that included informationabout using Semax in ischemic stroke. Data suitable for meta-analysis were confined to a score of more than 10 pointsfor the research quality, using the NIHS and Rankin scales, the Rivermead mobility index, assessed at 10-14-21 day, andSemax 1% intranasal in the first 10-14 days in dose of 12-18 mg / day. A random effects meta-analysis was performed.Results: From PubMed 167 articles and elibrary.ru 197 articles, 8 studies (n = 654) were suitable for meta-analysis,3 (n=181) of them matched the inclusion criteria and had the same end points. In the group of patients receiving Semax,there was a significant stroke severity decrease reduction using NIHSS at 10-14 and 21 days in subgroups of severe strokeand stroke of moderate severity and only at 21 days for the subgroup of mild strokes compared to the placebo group. Amongpatients receiving Semax compared with placebo, the outcome of rehabilitation after a stroke with Rankine scale at the 21day was better only in subgroups of severe and moderate stroke. When assessing the mobility with Rivermead mobilityindex, significantly better results were observed in patients receiving Semax in all subgroups compared with placebo.Conclusion: Semax 1% intranasal administration in the acute period of stroke leads to neurological impairment decrease,mobility and functional independence increase. It is rational to conduct a multicenter, powerful double-blind study of Semaxeffectiveness in the acute stroke period. A standard study design is necessary for inclusion in the meta-analysis.


KEYWORDS: Semax, stroke, meta-analysis, NIHSS, Rankin, Rivermead mobility index


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.