Assessment of the efficacy of Cytoflavin in the acute phase of ischemic stroke: a systematic review and meta-analysis

Objective. To evaluate the effectiveness of Cytoflavin in conjunction with standard therapy compared to standard therapy alone in patients presenting during the acute phase of ischemic stroke (IS). Material and methods. A systematic literature review and meta-analysis were conducted to assess the efficacy of Cytoflavin (containing inosine, nicotinamide, riboflavin, and succinic acid; STPF POLYSAN, Ltd., Russia) in adult patients diagnosed with IS. The analysis encompassed both randomized and non-randomized controlled trials, assessing outcomes such as hospital mortality, neurological deficit (measured using the National Institutes of Health Stroke Scale, NIHSS), and functional outcomes (assessed using the modified Rankin Scale and Barthel Index). Results. The incorporation of Cytoflavin into standard treatment protocols was associated with a statistically significant reduction in mortality rates when compared to standard therapy alone (hazard ratio [HR]=0.53; 95% confidence interval [CI] 0.37; 0.76, p<0.001). Furthermore, there was a notable improvement in the regression of neurological deficits during the acute phase of IS, as evidenced by higher NIHSS scores and better functional outcomes (Barthel Index) in patients receiving Cytoflavin. Conclusion. The findings from this systematic review and meta-analysis indicate that the addition of Cytoflavin to standard therapy for ischemic stroke is associated with more favorable clinical outcomes, including decreased mortality, diminished neurological impairment, and improved functional outcomes at the end of the IS acute phase. It is imperative to consider the high heterogeneity in the functional scales data across studies when interpreting these effects.