Drugs for reducing iron in patients with acute stroke

Research has suggested that disturbances in iron levels may be linked to brain damage after stroke. Limiting the toxicity that may be caused by iron following stroke is a promising treatment possibility. Iron chelators work in the body to bind excess iron in the blood and may reduce iron build-up and iron-related brain injury. In animal studies, iron chelators have been shown to protect brain tissue in the presence of a stroke. We searched for all randomized controlled trials looking at the effects of iron chelators in patients with acute stroke. We focused our search on trials where the treated group received iron chelator therapy and the control group received a non-active treatment (placebo) or no treatment. We did not find any completed trials in patients with acute stroke. Currently there is insufficient evidence to support or refute the use of iron chelators for the treatment of acute stroke but there is at least one ongoing trial.

Authors' conclusions: 

There is insufficient evidence to support or refute the use of iron chelators for the treatment of acute stroke. Further RCTs are required to assess the effect of iron chelators in people with acute stroke.

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Background: 

Stroke is a serious public health problem that causes morbidity and mortality throughout the world. Iron chelators are potential neuroprotective drugs to treat patients with both hemorrhagic and ischemic stroke.

Objectives: 

To evaluate the effectiveness and safety of the administration of iron chelators in patients with acute stroke.

Search strategy: 

We searched the Cochrane Stroke Group Trials Register (May 2012), the Chinese Stroke Trials Register (May 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE (1950 to May 2012), EMBASE (1980 to May 2012), Science Citation Index (1980 to May 2012) and three Chinese databases. In an effort to identify further published, unpublished and ongoing trials we searched ongoing trials registers, checked reference lists, and contacted authors and pharmaceutical companies.

Selection criteria: 

We included published and unpublished randomized controlled trials (RCTs) of iron chelator versus no iron chelator or placebo for the treatment of acute stroke.

Data collection and analysis: 

Two review authors independently screened search results to identify the full texts of potentially relevant studies for inclusion. From the results of the screened searches two review authors independently selected trials meeting the inclusion criteria, with no disagreement.

Main results: 

We found no completed RCTs eligible for inclusion in the review. We identified one ongoing RCT but no data were available.

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