Stroke: piracetam had no clear effect on death or dependency.

Clinical bottom line (level 1a-)

  1. Patients with acute ischaemic stroke who were given piracetam had no clear difference in death at one month, than those given placebo.
  2. Patients given piracetam had no clear difference in death or dependency at one month, than those given placebo.
Ricci et al: The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
Expires June 2003

The study

Systematic review of unconfounded, truly randomised trials of
  • Patients: stroke treated within 48 hours
  • Intervention: piracetam compared with placebo or open control
  • Outcome: death at one month, and death and dependency


    • Articles found in ? language using Cochrane Stroke Review Group trials register, MEDLINE, EMBASE, BIDIS ISI, from 1965 (search terms: standard Cochrane strategy used ) and contacted manufacturers and handsearched fifteen journals.

    Selection criteria: as above
    Appraisal criteria: detailed in text
    Articles excluded if: studies with no CT diagnosis of stroke or no definition of the interval between event and inclusion.

    Three trials involving 1002 patients were included.
    There was no statistical heterogeneity.

    The evidence

    Outcome Time to outcome CER OR
    (95% CI)    		 NN?
    (% CI)
    death 1 months /
    (%)    		 1.31
    (0.95 to 1.81)
    death or dependency 1 months /
    (%)    		 1.01
    (0.77 to 1.32)

    Comments

    1. A large RCT is awaiting completion and publication.
    2. 97% of the data came from one trial.

    Citation

    1. Ricci S, Celani MG, Cantisani AT, et al: Piracetam for acute ischaemic stroke (Cochrane Review). The Cochrane Library, Issue 2, Oxford: Update Software 1999; 2: -
    Contributor: Clare Wotton and Bob Phillips, December 1999
    Reviewer:

    Clinical Question.
    Patient acute stroke
    Intervention or Exposure piracetam
    Comparison placebo or open control
    Outcome death or dependency