Nimodipine in animal model experiments of focal cerebral ischemia - A systematic review

Background and Purpose-Based on the results of animal experiments, clinical trials were performed with nimodipine, which did not demonstrate a benefic ial effect on outcome after stroke. The aim of this study was to determine whether the evidence from animal experiments with nimodipine supported the use of nimodipine in clinical trials. Methods-We performed a systematic review of animal experiments with nimodip ine in focal cerebral ischemia. Studies were identified by searching Medlin e and Embase. We assessed whether these studies showed a beneficial effect of active treatment. In-depth analyses were performed on infarct size and a mount of edema, and subgroup analyses were performed on the length of the t ime window to the initiation of treatment and the methodological quality of the studies. Results-Of 225 identified articles, 20 studies were included. The methodolo gical quality of the studies was poor. Of the included studies, 50% were in favor of nimodipine. In-depth analyses showed statistically significant ef fects in favor of treatment (10 studies). No influence of the length of tim e to the initiation of treatment or of the methodological quality on the re sults was found. Conclusions-We conclude that the results of this review did not show convin cing evidence to substantiate the decision to perform trials with nimodipin e in large numbers of patients. There were no differences between the resul ts of the animal experiments and clinical studies. Surprisingly, we found t hat animal experiments and clinical studies ran simultaneously.