Neurological Sciences

, Volume 40, Issue 2, pp 235–241 | Cite as

Efficacy and safety of edaravone in treatment of amyotrophic lateral sclerosis—a systematic review and meta-analysis

  • Linting Luo
  • Zhibin SongEmail author
  • Xiaoqiang Li
  • Huiwang
  • Yaqing Zeng
  • Qinwang
  • Meiqi
  • Jianli He
Review Article



Based on the results of randomized, double-blind, placebo-controlled trials, the benefit and safety of edaravone in the treatment of amyotrophic lateral sclerosis remain controversial. We performed a meta-analysis to evaluate the efficacy and safety of edaravone in the treatment of this disease.


We searched PubMed, the Cochrane Library, and Embase from the inception of electronic data to April 2018. We included randomized, double-blind, placebo-controlled trials reporting amyotrophic lateral sclerosis patients receiving 60-mg intravenous edaravone or intravenous saline placebo for 24 weeks. The primary efficacy evaluation was changed in Amyotrophic Lateral Sclerosis Functional Rating Scale score from baseline to after the trial. Measure of safety was the frequency of investigated adverse events and serious adverse events. Data synthesis and analysis and evaluation of risk of bias were performed using RevMan 5.3 software. Heterogeneity among studies was evaluated with the I2 statistic.


A total of 367 patients were analyzed across three randomized controlled trials (183 patients receiving intravenous edaravone; 184 receiving placebo). A difference in ALSFRS-R score between groups at 24 weeks was found (mean difference [MD] = 1.63, 95% confidence interval [CI] 0.26–3.00, P = .02). No differences in the frequency of adverse events (odds ratio [OR] = 1.22, 95% CI 0.68–2.19, P = .50) or serious adverse events (OR = 0.71, 95% CI 0.43–1.19, P = .20) were found.


Intravenous edaravone is efficacious in amyotrophic lateral sclerosis patients, with no severe adverse effects. Additional reliable randomized controlled trials with larger sample sizes will further assess the efficacy and safety of edaravone in amyotrophic lateral sclerosis.

Clinical trial registration

The systematic review and meta-analysis was registered in the international prospective register of systematic reviews. (PROSPERO registration number: CRD42018096191;


Amyotrophic lateral sclerosis Edaravone ALSFRS-R score 



Amyotrophic lateral sclerosis


Amyotrophic lateral sclerosis functional rating scale


Review manager


Randomized controlled trials


Mean difference


Confidence interval


Odds ratio

Supplementary material

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ESM 1 (DOC 58 kb)
10072_2018_3653_MOESM2_ESM.docx (14 kb)
ESM 2 (DOCX 13 kb)
10072_2018_3653_MOESM3_ESM.doc (51 kb)
ESM 3 (DOC 51 kb)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Linting Luo
    • 1
  • Zhibin Song
    • 1
    Email author
  • Xiaoqiang Li
    • 1
  • Huiwang
    • 1
  • Yaqing Zeng
    • 1
  • Qinwang
    • 1
  • Meiqi
    • 1
  • Jianli He
    • 1
  1. 1.Department of Neurology, Affiliated Xiaolan HospitalSouthern Medical UniversityZhongshanChina

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