Abstract Details

Title Glibenclamide For Patients With Acute Aneurysmal Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 13-003

Objective We aimed to perform a systematic review and meta-analysis assessing the safety and efficacy outcomes in patients with acute aneurysmal subarachnoid hemorrhage comparing treatment with glibenclamide versus placebo.

Background Acute aneurysmal subarachnoid hemorrhage is a subtype of stroke frequently associated with disability. Glibenclamide is an antidiabetic that can cause hypoglycemia. Previous clinical studies and randomized controlled trials demonstrated that glibenclamide could have neuroprotective effects, including reduced cerebral edema and improved functional prognosis, as measured with the modified rankin scale (mRS), in patients with acute aneurysmal subarachnoid hemorrhage.

Design/Methods PubMed, Scopus, Cochrane and Web of Science databases were systematically searched for randomized controlled trials (RCTs) and observational studies comparing glibenclamide with placebo in patients with acute aneurysmal subarachnoid hemorrhage. Outcomes assessed were mean overall discharge mRS, mean discharge mRS between patients with favorable outcome, mean mRS after six months, hydrocephalus, hypoglycemia and delayed cerebral infarction (DCI). Statistical analysis was performed using RStudio. Heterogeneity was assessed with I² statistics.

Results Five studies met inclusion criteria, four RCTs and one observational study. A total of 419 patients were included, of whom 162 (38,67%) received treatment with glibenclamide and 257 (61,33%) received placebo. No statistical differences were found in mean overall discharge mRS, mean discharge mRS between patients with favorable outcome and hydrocephalus. Mean mRS after six months was significantly lower with treatment with glibenclamide (MD -0.88; 95% CI -1.32 to -0.44; P = 0.000086; I2 = 0%). DCI incidence was significantly lower with treatment with glibenclamide (OR 0.52; 95% CI 0.31 to 0.89; P = 0.017; I2 = 0%). Hypoglycemia was significantly higher with placebo (OR 3.80; 95% CI 1.01 to 14.30; P = 0.0479; I2 = 0%).

Conclusions Our findings suggest that glibenclamide is effective for neuroprotection in the treatment of acute aneurysmal subarachnoid hemorrhage.

Authors/Disclosures
Julia Mello, Student PRESENTER	Mrs. Mello has nothing to disclose.
Barbara Antonia D. Talah, Medical Student	Miss Talah has nothing to disclose.
Helen C. Beckert	Miss Beckert has nothing to disclose.
Giovanna Pontirolli	Miss Pontirolli has nothing to disclose.
Nuris M. Torres Argota, Sr.	Dr. Torres Argota has nothing to disclose.
Manuela B. Teles	Miss Teles has nothing to disclose.
Hamilton Roberto Moreira de Oliveira Carrico	Mr. Roberto Moreira de Oliveira Carrico has nothing to disclose.

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