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Granulocyte colony stimulating factor therapy for stroke: A pairwise meta-analysis of randomized controlled trial.

Abstract Granulocyte colony-stimulating factor (G-CSF) is atherapeutic candidate for stroke that has demonstrated anti-inflammatory and neuroprotective properties. Data from preclinical and clinical studies have suggested the safety and efficacy of G-CSF in stroke; however, the exact effects and utility of this cytokine in patients remain disputed. We performed a meta-analysis of randomized controlled trials of G-CSF in ischemic and hemorrhagic stroke to assess its clinical safety and efficacy. Electronic databases were searched for relevant publications in English and Chinese. A total of 14 trials met the inclusion criteria. G-CSF (cumulative dose range, 1-135μg/kg/day) was tested against placebo in a total of 1037 participants. There was no difference in the rate of mortality between groups (odds ratio, 1.23; 95% confidence interval, 0.76-1.97, p = 0.40). Moreover, the rate of serious adverse events did not differ between groups and provided evidence for the safety of G-CSF administration in stroke patients (odds ratio, 1.11; 95% confidence interval, 0.77-1.61, p = 0.57). No significant outcome benefits were noted with respect to the National Institutes of Health Stroke Scale (mean difference, -0.16; 95% confidence interval, -1.02-0.70, p = 0.72); however, improvements were noted with respect to the Barthel Index (mean difference, 8.65; 95% confidence interval 0.98-16.32; p = 0.03). In conclusion, it appears to be safe in administration of G-CSF, but it will increase leukocyte count. G-CSF was weakly significant benefit with improving the BI scores, while there was no improvement in the NIHSS scores. Larger and more robustly designed trials of G-CSF in stroke are needed to confirm the results.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 28406964
OWN - NLM
STAT- In-Process
DA  - 20170413
LR  - 20170413
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Granulocyte colony stimulating factor therapy for stroke: A pairwise
      meta-analysis of randomized controlled trial.
PG  - e0175774
LID - 10.1371/journal.pone.0175774 [doi]
AB  - Granulocyte colony-stimulating factor (G-CSF) is atherapeutic candidate for
      stroke that has demonstrated anti-inflammatory and neuroprotective properties.
      Data from preclinical and clinical studies have suggested the safety and efficacy
      of G-CSF in stroke; however, the exact effects and utility of this cytokine in
      patients remain disputed. We performed a meta-analysis of randomized controlled
      trials of G-CSF in ischemic and hemorrhagic stroke to assess its clinical safety 
      and efficacy. Electronic databases were searched for relevant publications in
      English and Chinese. A total of 14 trials met the inclusion criteria. G-CSF
      (cumulative dose range, 1-135mug/kg/day) was tested against placebo in a total of
      1037 participants. There was no difference in the rate of mortality between
      groups (odds ratio, 1.23; 95% confidence interval, 0.76-1.97, p = 0.40).
      Moreover, the rate of serious adverse events did not differ between groups and
      provided evidence for the safety of G-CSF administration in stroke patients (odds
      ratio, 1.11; 95% confidence interval, 0.77-1.61, p = 0.57). No significant
      outcome benefits were noted with respect to the National Institutes of Health
      Stroke Scale (mean difference, -0.16; 95% confidence interval, -1.02-0.70, p =
      0.72); however, improvements were noted with respect to the Barthel Index (mean
      difference, 8.65; 95% confidence interval 0.98-16.32; p = 0.03). In conclusion,
      it appears to be safe in administration of G-CSF, but it will increase leukocyte 
      count. G-CSF was weakly significant benefit with improving the BI scores, while
      there was no improvement in the NIHSS scores. Larger and more robustly designed
      trials of G-CSF in stroke are needed to confirm the results.
FAU - Huang, Xin
AU  - Huang X
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
FAU - Liu, Yu
AU  - Liu Y
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
FAU - Bai, Shuang
AU  - Bai S
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
FAU - Peng, Lidan
AU  - Peng L
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
FAU - Zhang, Boai
AU  - Zhang B
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
FAU - Lu, Hong
AU  - Lu H
AD  - Department of Neurology, The First Affiliated Hospital of Zhengzhou University,
      Henan, China.
LA  - eng
PT  - Journal Article
DEP - 20170413
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/04/14 06:00
MHDA- 2017/04/14 06:00
CRDT- 2017/04/14 06:00
PHST- 2016/07/28 [received]
PHST- 2017/03/22 [accepted]
AID - 10.1371/journal.pone.0175774 [doi]
AID - PONE-D-16-29303 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 13;12(4):e0175774. doi: 10.1371/journal.pone.0175774.
      eCollection 2017.

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