Lumbrokinase Reduced the Fibrinogen Concentration in Ischemic Cerebrovascular Disease Patients: A Systematic Review and Meta-Analysis - Yedy P. Sukmawan (Indonesian Journal of Clinical Pharmacy, 2020)
Lumbrokinase has been used to treat stroke and cardiovascular disease. Fibrinogen elevation is a known risk factor and a powerful predictor of ischemic cerebrovascular disease. The objective of this study was to conduct a systematic review and meta-analysis of the effects of lumbrokinase treatment on fibrinogen concentration and blood and plasma viscosities. The search strategy included articles indexed by PubMed and other resources (Google Search), using medical subject headings (MeSH) and text words. A total of 185 articles were identified; however, only two articles were included in the final analysis, including 727 patients. The results demonstrated a significant reduction in the fibrinogen concentration (–0.67, 95% confidence interval [95% CI] [–1.22, –0.12]; p=0.02) and a significant reduction in plasma viscosity (–0.77, 95% CI [–1.06, –0.48]; p=0.00001) for the lumbrokinase-treatment group compared with the control group. However, no significant difference in blood viscosity was observed between the two groups (–0.61, 95% CI [–1.33, 0.11]; p=0.10). Lumbrokinase may be effective as an adjuvant drug alongside the standard treatment for ischemic cerebrovascular disease. However, these results should be interpreted with caution due to high heterogeneity, and further randomized controlled trials are necessary.Keywords: Fibrinogen, ischemic cerebrovascular disease, lumbrokinase Lumbrokinase Menurunkan Konsentrasi Fibrinogen pada Pasien Penyakit Iskemik Serebrovaskular: Kajian Sistematik dan Meta-AnalisisAbstrakLumbrokinase telah digunakan untuk penatalaksanaan strok dan penyakit kardiovaskular. Peningkatan konsentrasi fibrinogen telah diketahui sebagai faktor risiko dan prediktor yang sangat kuat untuk penyakit iskemik serebrovaskular. Tujuan review sistematik dan meta-analisis ini adalah untuk menganalisis efek lumbrokinase terhadap konsentrasi fibrinogen, viskositas darah dan viskositas plasma. Strategi pencarian artikel meliputi pencarian artikel pada database PubMed dan sumber lainnya (Worldwide Website/Google Search) dengan menggunakan medical subject heading (MeSH) dan textword. Sebanyak 185 artikel teridentifikasi, tetapi hanya 2 artikel (melibatkan 727 pasien) yang memenuhi kriteria inklusi. Hasil analisis menunjukkan bahwa lumbrokinase dapat menurunkan konsentrasi fibrinogen dibandingkan terhadap kelompok kontrol (–0,67, 95% CI [–1,22, –0,12] ; p=0,02). Selain itu, lumbrokinase juga dapat menurunkan viskositas plasma secara signifikan bila dibandingkan dengan kelompok kontrol (–0,77, 95% confidence interval [95% CI] [–1,06, –0,48]; p=0,00001). Efek lumbrokinase terhadap viskositas darah, meskipun terjadi penurunan terhadap viskositas darah, tidak menunjukkan signifikansi bila dibandingkan kelompok kontrol (–0,61, 95% CI [–1,33, 0,11]; p=0,10). Lumbrokinase mungkin efektif untuk penyakit iskemik serebrovaskular, namun hasil ini harus diinterpretasikan dengan hati-hati disebabkan heterogenitas yang tinggi, selain itu diperlukan lebih banyak penelitian dengan desain randomized controlled trial.Kata kunci: Fibrinogen, lumbrokinase, penyakit iskemik serebrovaskular