Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis

England, Timothy J. and Sprigg, Nikola and Alasheev, Andrey M. and Belkin, Andrey A. and Kumar, Amit and Prasad, Kameshwar and Bath, Philip M.W. (2016) Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis. Scientific Reports, 6 . 36567/1-36567/7. ISSN 2045-2322

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Abstract

Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trials (RCT) assessing G-CSF in patients with hyperacute, acute, subacute or chronic stroke, and asked Investigators to share individual patient data on baseline characteristics, stroke severity and type, end-of trial modified Rankin Scale (mRS), Barthel Index, haematological parameters, serious adverse events and death. Multiple variable analyses were adjusted for age, sex, baseline severity and time-to-treatment. Individual patient data were obtained for 6 of 10 RCTs comprising 196 stroke patients (116 G-CSF, 80 placebo), mean age 67.1 (SD 12.9), 92% ischaemic, median NIHSS 10 (IQR 5-15), randomised 11 days (interquartile range IQR 4-238) post ictus; data from three commercial trials were not shared. G-CSF did not improve mRS (ordinal regression), odds ratio OR 1.12 (95% confidence interval 0.64 to 1.96, p=0.62). There were more patients with a serious adverse event in the G-CSF group (29.6% versus 7.5%, p=0.07) with no significant difference in all-cause mortality (G-CSF 11.2%, placebo 7.6%, p=0.4). Overall, G-CSF did not improve stroke outcome in this individual patient data meta-analysis.

Item Type: Article
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Clinical Neuroscience
University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Medical Sciences and Graduate Entry Medicine
Identification Number: 10.1038/srep36567
Depositing User: Eprints, Support
Date Deposited: 01 Nov 2016 12:35
Last Modified: 16 Oct 2017 00:31
URI: http://eprints.nottingham.ac.uk/id/eprint/38398

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