Comparison between clevidipine and nicardipine in cerebrovascular diseases: A systematic review and meta-analysis

Clin Neurol Neurosurg. 2023 Apr:227:107644. doi: 10.1016/j.clineuro.2023.107644. Epub 2023 Feb 23.

Abstract

Purpose: The term "cerebrovascular diseases (CVDs)" refers to a broad category of diseases that affect the brain's blood vessels and cerebral circulation. Controlling acute hypertension (HTN) by antihypertensive drugs such as clevidipine and nicardipine can be a highly efficient method of lowering the incidence of CVDs.

Methods: This is a systematic review and meta-analysis study. The PubMed, Scopus, and Web of Science online databases and a gray literature search were performed to identify potentially eligible studies. The included studies were observational studies that compared adult patients receiving clevidipine or nicardipine for controlling HTN in the setting of CVD.

Results: We reviewed 5 final included articles, including 546 patients. The pooled standardized mean difference (SMD) for time to goal SBP was - 0.04 (95 % CI: [-0.66; 0.58], p-value: 0.86, I2: 79.0 %, pooled MD: -12.90 min), meaning that the clevidipine group had a shorter time to goal systolic blood pressure (SBP) than the nicardipine group. The pooled SMD for total volume infusion was - 0.52 (95 % CI: [-0.93; -0.12], p-value: 0.03, I2: 0.0 %, pooled MD: -1118.81 mL), showing a notably lower total volume infused into patients in the clevidipine group.

Conclusions: We found that clevidipine reaches the SBP goal faster than nicardipine; however, there was no statistically significant difference between the two drugs. The total volume infused to achieve the goal SBP was significantly lower in the clevidipine group. Further prospective studies are needed to compare clevidipine and nicardipine in CVD patients on a large scale.

Keywords: Cerebrovascular Diseases; Clevidipine; Meta-analysis; Nicardipine; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Calcium Channel Blockers / pharmacology
  • Calcium Channel Blockers / therapeutic use
  • Cerebrovascular Disorders* / complications
  • Cerebrovascular Disorders* / drug therapy
  • Humans
  • Hypertension*
  • Nicardipine / therapeutic use

Substances

  • Nicardipine
  • clevidipine
  • Calcium Channel Blockers
  • Antihypertensive Agents