Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis
Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trial...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Published: |
Nature Publishing Group
2016
|
| Online Access: | https://eprints.nottingham.ac.uk/38398/ |
| _version_ | 1848795602478956544 |
|---|---|
| author | England, Timothy J. Sprigg, Nikola Alasheev, Andrey M. Belkin, Andrey A. Kumar, Amit Prasad, Kameshwar Bath, Philip M.W. |
| author_facet | England, Timothy J. Sprigg, Nikola Alasheev, Andrey M. Belkin, Andrey A. Kumar, Amit Prasad, Kameshwar Bath, Philip M.W. |
| author_sort | England, Timothy J. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trials (RCT) assessing G-CSF in patients with hyperacute, acute, subacute or chronic stroke, and asked Investigators to share individual patient data on baseline characteristics, stroke severity and type, end-of trial modified Rankin Scale (mRS), Barthel Index, haematological parameters, serious adverse events and death. Multiple variable analyses were adjusted for age, sex, baseline severity and time-to-treatment. Individual patient data were obtained for 6 of 10 RCTs comprising 196 stroke patients (116 G-CSF, 80 placebo), mean age 67.1 (SD 12.9), 92% ischaemic, median NIHSS 10 (IQR 5-15), randomised 11 days (interquartile range IQR 4-238) post ictus; data from three commercial trials were not shared. G-CSF did not improve mRS (ordinal regression), odds ratio OR 1.12 (95% confidence interval 0.64 to 1.96, p=0.62). There were more patients with a serious adverse event in the G-CSF group (29.6% versus 7.5%, p=0.07) with no significant difference in all-cause mortality (G-CSF 11.2%, placebo 7.6%, p=0.4). Overall, G-CSF did not improve stroke outcome in this individual patient data meta-analysis. |
| first_indexed | 2025-11-14T19:34:42Z |
| format | Article |
| id | nottingham-38398 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:34:42Z |
| publishDate | 2016 |
| publisher | Nature Publishing Group |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-383982020-05-04T18:21:00Z https://eprints.nottingham.ac.uk/38398/ Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis England, Timothy J. Sprigg, Nikola Alasheev, Andrey M. Belkin, Andrey A. Kumar, Amit Prasad, Kameshwar Bath, Philip M.W. Granulocyte colony stimulating factor (G-CSF) may enhance recovery from stroke through neuroprotective mechanisms if administered early, or neurorepair if given later. Several small trials suggest administration is safe but effects on efficacy are unclear. We searched for randomised controlled trials (RCT) assessing G-CSF in patients with hyperacute, acute, subacute or chronic stroke, and asked Investigators to share individual patient data on baseline characteristics, stroke severity and type, end-of trial modified Rankin Scale (mRS), Barthel Index, haematological parameters, serious adverse events and death. Multiple variable analyses were adjusted for age, sex, baseline severity and time-to-treatment. Individual patient data were obtained for 6 of 10 RCTs comprising 196 stroke patients (116 G-CSF, 80 placebo), mean age 67.1 (SD 12.9), 92% ischaemic, median NIHSS 10 (IQR 5-15), randomised 11 days (interquartile range IQR 4-238) post ictus; data from three commercial trials were not shared. G-CSF did not improve mRS (ordinal regression), odds ratio OR 1.12 (95% confidence interval 0.64 to 1.96, p=0.62). There were more patients with a serious adverse event in the G-CSF group (29.6% versus 7.5%, p=0.07) with no significant difference in all-cause mortality (G-CSF 11.2%, placebo 7.6%, p=0.4). Overall, G-CSF did not improve stroke outcome in this individual patient data meta-analysis. Nature Publishing Group 2016-11-15 Article PeerReviewed England, Timothy J., Sprigg, Nikola, Alasheev, Andrey M., Belkin, Andrey A., Kumar, Amit, Prasad, Kameshwar and Bath, Philip M.W. (2016) Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis. Scientific Reports, 6 . 36567/1-36567/7. ISSN 2045-2322 http://www.nature.com/articles/srep36567 doi:10.1038/srep36567 doi:10.1038/srep36567 |
| spellingShingle | England, Timothy J. Sprigg, Nikola Alasheev, Andrey M. Belkin, Andrey A. Kumar, Amit Prasad, Kameshwar Bath, Philip M.W. Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title | Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title_full | Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title_fullStr | Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title_full_unstemmed | Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title_short | Granulocyte-colony stimulating factor (G-CSF) for stroke: an individual patient data meta-analysis |
| title_sort | granulocyte-colony stimulating factor (g-csf) for stroke: an individual patient data meta-analysis |
| url | https://eprints.nottingham.ac.uk/38398/ https://eprints.nottingham.ac.uk/38398/ https://eprints.nottingham.ac.uk/38398/ |