Effects of deferoxamine treatment in patients with spontaneous cerebral hemorrhage: A meta-analysis

Background: Deferoxamine (DFX) is reckoned effective for treating intracerebral hematoma (ICH). However, its therapeutic effects remain controversial. Although one systematic review was conducted previously, the pooled data analysis could not be done owing to the limited studies included. In our study, we searched additional databases and included more studies to conduct a meta-analysis on the therapeutic effects of DFX considering hematoma absorption, relative edema volume, and neurological prognosis of ICH patients.Methods: We searched Embase, Cochrane Library, PubMed, Web of Science, Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Clinical Trials.gov in May 2020 for studies on DFX for ICH patients. The quality of randomized controlled trials (RCTs) was assessed using the Cochrane Risk of Bias Tool and that of cohort studies using the Newcastle-Ottawa Scale. Random-effect and fixed-effect models were used for pooled analysis.Results: After screening 1820 articles, 3 cohort studies, and 5 RCTs were included. We found that DFX exhibits no therapeutic effects with regard to hematoma absorption on the days 7 and 14 after onset. DFX could suppress edema expansion on days 3 and 7 after onset, however, there was a difference on day 14. Regarding neurological outcomes, DFX did not lead to better outcomes after both one week and 15 days when evaluated using the National Institute of Health Stroke Scale and after 3 months using the modified Rankin scale. There was no obvious advantage despite including an unpublished study on using high dose DFX to evaluate neurological outcomes 3 months after onset.Conclusions: DFX could impede edema expansion on days 3 and 7 after onset without promoting hematoma absorption, neither improving neurological outcomes.