Objective  To rapidly evaluate the effectiveness, safety and economy of edaravone in treating acute ischemic stroke (AIS), and to provide the evidence-based basis for clinical decision-making.

Methods  PubMed, Embase, Web of Science, Cochrane Library, CNKI and WanFang Data databases and the official website of health technology assessment (HTA) agency were electronically searched to collect HTA reports, systematic reviews/Meta-analysis and pharmacoeconomic studies of edaravone in the treatment of AIS from the inception to October 1, 2024. Two reviewers independently screened the literature, extracted data, evaluated the quality, summarized the results, and qualitatively described and analyzed the results.

Results  A total of 12 literature were included, involving 9 systematic reviews/Meta-analysis and 3 pharmacoeconomic studies. In terms of efficacy, edaravone alone or in combination with conventional therapy (alteplase, ozagrel) increased efficiency, improved short-term neurological deficit scores and improved patients' ability to perform activities of daily living compared with placebo or conventional therapy (alteplase, ozagrel) (P﹤0.05). There was no significant difference in the incidence of adverse reactions between edaravone and placebo, routine treatment, or other neuroprotectants (P>0.05). Combined with alteplase, it could reduce the incidence of intracranial hemorrhage compared to alteplase alone (P﹤0.05), with no statistically significant difference in all-cause mortality (P﹤0.05). Pharmacoeconomic studies showed that, edaravone does not have a cost-effectiveness advantage in the short term, but it may have a cost-effectiveness advantage from limited long-term studies.

Conclusion   Edaravone is effective and safe in the treatment of AIS, but there is limited research evidence and the conclusion still needs to be confirmed by further studies and clinical trials, and the economics need to be further evaluated.

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