Effectiveness comparisons of drug therapies for postoperative aneurysmal subarachnoid hemorrhage patients: network meta‑analysis and systematic review

Abstract Objective To compare the effectiveness of various drug interventions in improving clinical outcome postoperative patients after aneurysmal subarachnoid hemorrhage (aSAH) and assist determining drugs definite curative effect prognosis. Methods Eligible Randomized Controlled Trials (RCTs) were searched databases PubMed, EMBASE, Cochrane Library (inception to Sep 2020). Glasgow Outcome Scale (GOS) score, Extended (GOSE) score or modified Rankin (mRS) was used as main measurements evaluate efficacy outcomes with aSAH. The network meta-analysis (NMA) conducted based on a random-effects model, dichotomous variables determined by using odds ratio (OR) 95% confidence interval (CI), surface under cumulative ranking curve (SUCRA) generated estimate probability comparative among different therapies. Results From 493 initial citation screening, forty-four RCTs (n = 10,626 participants) eventually included our analysis. Our NMA results showed that cilostazol (OR 3.35,95%CI 1.50,7.51) best intervention improve (SUCRA 87.29%, 95%CrI 0.07–0.46). Compared placebo group, only two [nimodipine 1.61, 95%CI 1.01,2.57) 3.35, 1.50, 7.51)] achieved significant statistical significance patients. Conclusions Both nimodipine have exact aSAH, may be aSAH operation. study provides implications for future studies that, combination more relative safety potential benefits (e.g., cilostazol) effectively.