Effect of progesterone administration on the prognosis of patients with severe traumatic brain injury: a meta-analysis of randomized clinical trials
Open Access
- 1 January 2019
- journal article
- research article
- Published by Taylor & Francis Ltd in Drug Design, Development and Therapy
- Vol. ume 13, 265-273
- https://doi.org/10.2147/dddt.s192633
Abstract
Effect of progesterone administration on the prognosis of patients with severe traumatic brain injury: a meta-analysis of randomized clinical trials Zhi-Yong Pan, Yu-Hang Zhao, Wen-Hong Huan, Zhi-Ze Xiao, Zhi-Qiang Li Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China Purpose: The aim of this study was to assess the neuroprotective effect of progesterone administration on severe traumatic brain injury (TBI) for different follow-up periods and administration route by completing a meta-analysis of randomized clinical trials (RCTs).Methods: A systematic literature search of PubMed, Embase, and Cochrane databases and the Web of Science (from establishment of each to September 1, 2018) was performed to identify original RCTs that evaluated the associations between progesterone treatment and the prognosis of patients with severe TBI.Results: Eight RCTs enrolling 2,251 patients with severe TBI were included. Within 3 months post-injury, patients with progesterone administration had a lower mortality (risk ratio [RR] =0.59; 95% CI [0.42–0.81], P=0.001) and better neurologic outcomes (RR =1.51; 95% CI [1.12–2.02], P=0.007) than those who received placebo. However, these differences did not persist at 6 months post-injury for mortality (RR =0.96; 95% CI [0.65–1.41], P=0.83) or neurologic outcomes (RR =1.09; 95% CI [0.93–1.27], P=0.31). The analysis stratified by administration route showed that beneficial effects were only observed in patients who received progesterone intramuscularly (RR =1.61, 95% CI [1.19–2.18], P=0.002); no benefit was observed with intravenous administration (RR =0.99, 95% CI [0.91–1.07], P=0.75).Conclusion: Progesterone administration improved the clinical outcomes of severe TBI patients within 3 months but may not have significant long-term benefits 6 months post-injury. Keywords: progesterone, severe traumatic brain injury, neuroprotectionKeywords
This publication has 35 references indexed in Scilit:
- Progesterone attenuates cerebral edema in neonatal rats with hypoxic-ischemic brain damage by inhibiting the expression of matrix metalloproteinase-9 and aquaporin-4Experimental and Therapeutic Medicine, 2013
- Comparison of the administration of progesterone versus progesterone and vitamin D in improvement of outcomes in patients with traumatic brain injury: A randomized clinical trial with placebo groupIbnosina Journal of Medicine and Biomedical Sciences, 2012
- Acute Serum Hormone Levels: Characterization and Prognosis after Severe Traumatic Brain InjuryJournal of Neurotrauma, 2011
- Cognitive outcome in children and young adults who sustained severe and moderate traumatic brain injury 10 years earlierBrain Injury, 2009
- Improved outcomes from the administration of progesterone for patients with acute severe traumatic brain injury: a randomized controlled trialCritical Care, 2008
- Progesterone Improves Acute Recovery after Traumatic Brain Injury in the Aged RatJournal of Neurotrauma, 2007
- Much ado about nothing: a comparison of the performance of meta‐analytical methods with rare eventsStatistics in Medicine, 2006
- Progesterone suppresses the inflammatory response and nitric oxide synthase-2 expression following cerebral ischemiaExperimental Neurology, 2005
- Steady-State Serum Concentrations of Progesterone Following Continuous Intravenous Infusion in Patients With Acute Moderate to Severe Traumatic Brain InjuryThe Journal of Clinical Pharmacology, 2005
- Progesterone Facilitates Cognitive Recovery and Reduces Secondary Neuronal Loss Caused by Cortical Contusion Injury in Male RatsExperimental Neurology, 1994