Effectiveness and Safety of Fasudil Hydrochloride for Cerebral Vasospasm after Subarachnoid Hemorrhage:a Systematic Review

OBJECTIVE:To evaluate the effectiveness and safety of fasudil hydrochloride for cerebral vasospasm(CVS) after subarachnoid hemorrhage(SAH).METHODS:We retrieved from Medline(1975-2010),Cochrane Library Controlled Trials Database(1975-2010),CBMDisc(1979-2010),CNKI(1979-2010),VIP(1989-2010) and Wanfang database(1985-2010).The effectiveness of drug was evaluated with total effective rate,the incidence of cerebral vasospasm and low density focus;safety evalution contained the incidence of BP reduction and slight and severe ADR.Data were analyzed by Rev Man 5.0 software.RESULTS:22 RCT trials were included,involving 1 288 patients.Total effective rate of fasudil 30 mg,q8h was better than nimodipine 24 mg·d-1.There was statistical significance [RR=1.14,95%CI(1.03,1.26),P=0.01].Fasudil 30 mg,q8h was better than nimodipine 10 mg·d-1,there was statistical significance [RR=1.30,95%CI(1.11,1.52),P=0.001].The incidence of cerebral vasospasm in patients treated with fasudil 30 mg,q8h was lower than nimodipine 24 mg·d-1,there was no statistical significance [RR=0.78,95%CI(0.51,1.19),P=0.25].The incidence of low density focus in fasudil group(30 mg,q8h) was lower than in nimodipine group(24 mg·d-1),there was no statistical significance [RR=0.62,95%CI(0.27,1.42),P=0.26].Safety study showed fasudil resulted in few and slighter adverse drug reactions.CONCLUSION:Fasudil can increase effective rate and decrease incidence of cerebral vasospasm and low-density focus in the treatment of cerebral vasospasm after subarachnoid hemorrhage.Fasudil does not decrease blood pressure significantly but is safe for treatment.