{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T10:34:42Z","timestamp":1770719682967,"version":"3.49.0"},"reference-count":43,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Princ Pract"],"abstract":"<jats:p>&lt;p&gt;Objective: This systematic review and meta-analysis aimed to evaluate the clinical and radiological outcomes of glibenclamide versus control in acute stroke. Methods: In accordance with PRISMA guidelines, a comprehensive literature search was conducted to identify relevant studies up to January 15, 2025. Efficacy outcomes included modified Rankin Scale (mRS) score at 3 and 6 months, Barthel index, midline shift at 72\u201396 h, serum matrix metalloproteinase-9 levels, and decompressive craniectomy. Safety analysis assessed the incidence of hypoglycemia, mortality, and serious adverse events (SAEs). Results: A total of seven randomized controlled trials involving 1,225 patients were included in the meta-analysis. No statistically significant differences were observed in the efficacy outcomes in the pooled analysis. In subgroup analysis of mRS, glibenclamide was superior in intracerebral hemorrhage (mean difference [MD] = \u22120.67, 95% confidence interval [CI] [\u22121, \u22120.34], p value &lt;0.0001) but not ischemic or subarachnoid hemorrhage subtypes (MD = \u22120.03, 95% CI [\u22120.34, 0.28], p value = 0.86) and (MD = 0.06, 95% CI [\u22120.6, 0.71], p value = 0.86), respectively. In terms of safety, there were no significant differences in SAE or mortality (odds ratio [OR] = 1.34, 95% CI [0.99, 1.8], p value = 0.06) and (OR = 0.67, 95% CI [0.31, 1.45], p value = 0.31), respectively. However, glibenclamide was associated with an increased risk of hypoglycemia (OR = 5.03, 95% CI [2.17, 11.66], p value = 0.0002). Conclusion: The use of glibenclamide did not demonstrate improved outcomes in patients with acute stroke. However, real-time pharmacokinetic monitoring, identifying optimal administration route, and patient subgroups, which may potentially benefit from glibenclamide are essential before the drug\u2019s efficacy can be conclusively determined. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000547648","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T16:02:52Z","timestamp":1753718572000},"page":"45-61","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Glibenclamide on Functional Outcomes and Cerebral Edema following Ischemic and Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials"],"prefix":"10.1159","volume":"35","author":[{"given":"Amir","family":"Hegazi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2962-0075","authenticated-orcid":false,"given":"Rashad 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