Propranolol or Beta-Blockers for Cerebral Cavernous Malformation: a Systematic Review and Meta-analysis of Literature in Both Preclinical and Clinical Studies.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: United States NLM ID: 101517297 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1868-601X (Electronic) Linking ISSN: 18684483 NLM ISO Abbreviation: Transl Stroke Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York : Springer
    • Subject Terms:
      Adrenergic beta-Antagonists*/therapeutic use ; Hemangioma, Cavernous, Central Nervous System*/drug therapy ; Propranolol*/therapeutic use; Animals ; Humans
    • Abstract:
      Cerebral cavernous malformation (CCM), either sporadic or familial, is a devastating vascular malformation affecting the central nervous system that can present with intracerebral hemorrhage, seizure, and new focal neurologic deficits resulting in substantial morbidity and mortality. To date, there is no effective evidence-based preventive regimen. There have been several preclinical and clinical studies investigating the potential mechanisms and benefits of beta-blockers, especially on propranolol. We aimed to conduct a systematic review on the published literature investigating the use of beta-blockers in the treatment of CCM, including both preclinical and clinical studies between 2008 and 2023 using public databases. A total of 2 preclinical studies and 6 clinical studies met the inclusion/exclusion criteria and were included. Data was extracted and synthesized from 5 clinical studies for meta-analysis. The meta-analysis failed to demonstrate a statistically significant protective effect of beta-blockers in preventing intracerebral hemorrhage or developing focal neurologic deficits in subjects with CCM (overall effect = 0.78 (0.20, 3.11), p = 0.73). Overall, there was a paucity of high quality clinical trials, partially due to limited cases of CCM. Addressing this gap may require collaborative efforts at a national or international level. In this review, we summarized all barriers and opportunities on this topic. Additionally, we proposed establishing an evidence-based approach on the use of beta-blockers in preventing recurrent hemorrhage and focal neurological deficits in patients with CCM.
      (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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    • Contributed Indexing:
      Keywords: Beta-blockers; Cavernoma; Cerebral cavernous malformation; Propranolol
    • Accession Number:
      0 (Adrenergic beta-Antagonists)
      9Y8NXQ24VQ (Propranolol)
    • Publication Date:
      Date Created: 20231019 Date Completed: 20241029 Latest Revision: 20241112
    • Publication Date:
      20241112
    • Accession Number:
      10.1007/s12975-023-01199-5
    • Accession Number:
      37857790