Comparison between clevidipine and nicardipine in cerebrovascular diseases: A systematic review and meta-analysis.

Ali Seifi, Amirhossein Azari Jafari, Seyyedmohammadsadeq Mirmoeeni, Muffaqam Shah, Mohammadjavad Azari Jafari, Shahrzad Nazari, Shafagh Asgarzadeh, Daniel Agustin Godoy

Journal: Clinical neurology and neurosurgery 2023;227():107644

PMID: 36842290

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Abstract

PURPOSE

The term "cerebrovascular diseases (CVDs)" refers to a broad category of diseases that affect the brain's blood vessels and cerebral circulation. Controlling acute hypertension (HTN) by antihypertensive drugs such as clevidipine and nicardipine can be a highly efficient method of lowering the incidence of CVDs.

METHODS

This is a systematic review and meta-analysis study. The PubMed, Scopus, and Web of Science online databases and a gray literature search were performed to identify potentially eligible studies. The included studies were observational studies that compared adult patients receiving clevidipine or nicardipine for controlling HTN in the setting of CVD.

RESULTS

We reviewed 5 final included articles, including 546 patients. The pooled standardized mean difference (SMD) for time to goal SBP was - 0.04 (95 % CI: [-0.66; 0.58], p-value: 0.86, I: 79.0 %, pooled MD: -12.90 min), meaning that the clevidipine group had a shorter time to goal systolic blood pressure (SBP) than the nicardipine group. The pooled SMD for total volume infusion was - 0.52 (95 % CI: [-0.93; -0.12], p-value: 0.03, I: 0.0 %, pooled MD: -1118.81 mL), showing a notably lower total volume infused into patients in the clevidipine group.

CONCLUSIONS

We found that clevidipine reaches the SBP goal faster than nicardipine; however, there was no statistically significant difference between the two drugs. The total volume infused to achieve the goal SBP was significantly lower in the clevidipine group. Further prospective studies are needed to compare clevidipine and nicardipine in CVD patients on a large scale.

Address: Department of Neurosurgery, Division of Neuro Critical Care, University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, TX, USA. Electronic address: [email protected].; Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, the Islamic Republic of Iran.; Deccan College of Medical Sciences, Owaisi Hospital and Research Centre, Hyderabad, Telangana State, India.; Department of Cell & Molecular Biology, Semnan University, Semnan, the Islamic Republic of Iran.; Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, the Islamic Republic of Iran.; Department of Neurology, Urmia Medical Science University (UMSU), Urmia, the Islamic Republic of Iran.; Neurointensive Care Unit, Sanatorio Pasteur; Hospital Carlos Malbran, Catamarca, Argentina.

DOI: 10.1016/j.clineuro.2023.107644

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MeSH Terms: Adult, Humans, Nicardipine, Calcium Channel Blockers, Antihypertensive Agents, Hypertension, Cerebrovascular Disorders, Blood Pressure