Citicoline for Treatment of Head Trauma. Systematic Review and Meta-analysis of Clinical Controlled Trials

Trabajos Distinguidos Neurología 01/2013; 3:4.


Background: Citicoline is a neuroprotective/neurorestorative drug used in several countries for the
treatment of traumatic brain injury. After the publication of the controversial COBRIT trial, the use of
citicoline has been questioned in this use, then it has been considered as necessary proceed to do a
systematic review to evaluate if citicoline is effective in the treatment of patients with traumatic brain
injury. Methods: A systematic search was performed on Medline, Embase, and Ferrer Group database to
identify all published, unconfounded, comparative clinical trials of citicoline in acute phase head injured
patients. Results: 12 controlled trials enrolling 2 706 patients were identified. Under the random-effects
model, the meta-analysis shows an 1.815 (IC 95:% 1.302-2.530) in favour of citicoline in the rates of
independence, using as measure the Galsgow Outcome Scale. The effect of citicoline has been diluted
across the time in parallel with the improvement of the standard of care of this kind of pacients, as demonstrated
by the cumulative meta-analysis technique. Conclusion: Formal meta-analysis of comparative
trials of citicoline in traumatic brain injury shows a beneficial treatment effect, without safety concerns.

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Available from: Julio J Secades