Systematic Review and Stratified Meta-analysis of the Efficacy of Interleukin-1 Receptor Antagonist in Animal Models of Stroke

Background: Interleukin (IL)-1 receptor antagonist (RA) is an anti-inflammatory protein used to treat arthritis that has also been identified as a candidate stroke drug. Methods: We conducted a systematic review and meta-analysis of reports of the efficacy of IL-1 RA in animal models of focal cerebral ischemia. Results: We identified 16 published sources and one unpublished source of data. IL-1 RA reduced infarct volume by 38.2% (95%, confidence interval 31.2%-45.1%). Efficacy was higher with higher doses, earlier treatment, and central administration of drug. No studies used animals with hypertension or diabetes or tested efficacy beyond 3 hours. Conclusions: The animal data supporting IL-1 RA as a candidate drug for stroke are limited, and further experiments are required before proceeding to clinical trial.