ABSTRACT NUMBER: ESOC2026A1708 EDARAVONE DEXBORNEOL AND NINETY DAY FUNCTIONAL RECOVERY IN ACUTE ISCHEMIC STROKE: A SYSTEMATIC REVIEW AND META ANALYSIS

Abstract Background and aims Neuroprotective therapies for acute ischemic stroke have largely failed to demonstrate consistent clinical benefit. Edaravone dexborneol, a dual antioxidant and anti inflammatory agent, has shown promising results in recent trials. We aimed to systematically evaluate the efficacy and safety of edaravone dexborneol in patients with acute ischemic stroke. Methods A systematic review and meta analysis were conducted in accordance with PRISMA guidelines. PubMed, Cochrane Library, Scopus, and Web of Science were searched from inception to December 30, 2024. Randomized controlled trials and observational studies comparing edaravone dexborneol with standard care, placebo, or edaravone alone were included. Primary outcomes were functional recovery measured by the modified Rankin Scale at 90 days and neurological improvement assessed by the National Institutes of Health Stroke Scale. Random and common effects models applied, and risk of bias assessed. Results Seven studies involving 2,942 patients were included. Pooled analysis demonstrated significantly higher odds of favorable functional outcome at 90 days with edaravone dexborneol (odds ratio 1.40, 95 percent confidence interval 1.18 to 1.65, p equals 0.0001), with no heterogeneity. NIHSS improvement showed a small effect under the common effect model but was not statistically significant under random effects due to heterogeneity. Secondary outcomes consistently favored edaravone dexborneol, including improved activities of daily living, cognitive function, reduced post stroke depression and inflammatory markers. Conclusions Edaravone dexborneol is associated with improved functional recovery and a favorable safety profile in acute ischemic stroke. These findings support its potential role as a neuroprotective therapy and highlight the need for large, multinational randomized trials. Conflict of interest Olivier Uwishema. nothing to disclose