Safety and efficacy of recovery-promoting drugs for motor function after stroke: a systematic review of randomized controlled trials

Firth, Nerida, Barker, Ruth N., Hayward, Kathryn S., Bernhardt, Julie, Bellingan, Michelle, and Gunnarsson, Ronny (2019) Safety and efficacy of recovery-promoting drugs for motor function after stroke: a systematic review of randomized controlled trials. Journal of Rehabilitation Medicine, 51 (5). pp. 319-330.

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Objective: To investigate the efficacy and safety of drug interventions to promote motor recovery post-stroke.

Data sources: CENTRAL, CINAHL, Embase, MEDLINE, SCOPUS and Web of Science.

Study selection: Published human randomized controlled trials in which the primary intervention was a drug administered to promote motor recovery post-stroke, vs placebo.

Data extraction: Standardized pro forma used to extract safety and efficacy data; Cochrane Collaboration risk of bias assessment tool performed to assess risk of bias.

Data synthesis: Fifty randomized controlled trials from 4,779 citations were included. An overall trend of high risk of attrition (n = 27) and reporting bias (n = 36) was observed. Twenty-eight different drug interventions were investigated, 18 of which demonstrated statistically significant results favouring increased motor recovery compared with control intervention. Forty-four studies measured safety; no major safety concerns were reported.

Conclusion: Candidate drug interventions promoting motor recovery post-stroke were identified, specifically selective serotonin reuptake inhibitors and levodopa; however, the high risk of bias in many trials is concerning. Drugs to improve motor function remain an important area of enquiry. Future research must focus on establishing the right drug intervention to be administered at an optimal dose and time, combined with the most effective adjuvant physical therapy to drive stroke recovery.

Item ID: 58335
Item Type: Article (Research - C1)
ISSN: 1651-2081
Keywords: pharmaceutical preparations, stroke, rehabilitation
Copyright Information: © 2019 Foundation of Rehabilitation Information. This is an Open Access article, distributed under the terms and conditions of the Creative Commons Attribution Non-Commercial Licence.
Funders: National Health and Medical Research Council (NHMRC), Victorian Government (VG)
Projects and Grants: NHMRC Early Career Fellowship (GNT1088449), VG Operational Infrastructure Support Program
Date Deposited: 22 May 2019 07:31
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3214 Pharmacology and pharmaceutical sciences > 321402 Clinical pharmacology and therapeutics @ 50%
42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420109 Rehabilitation @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920403 Disability and Functional Capacity @ 100%
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