# Butylphthalide reduces plaque burden and improves neurological function in carotid atherosclerotic disease: a pooled analysis

## TL;DR

Butylphthalide reduces carotid plaque and improves neurological function in atherosclerosis, suggesting it may help prevent stroke.

## Contribution

A pooled analysis showing butylphthalide's effectiveness in reducing plaque and improving neurological outcomes in carotid atherosclerosis.

## Key findings

- Butylphthalide significantly reduces carotid intima-media thickness and plaque size.
- It improves neurological function and lowers inflammatory biomarkers like hs-CRP and MMP-9.
- The treatment is associated with a high safety profile and comparable adverse events to controls.

## Abstract

The influence of butylphthalide on atherosclerotic plaque burden remains underexplored. This pooled analysis was aimed to evaluate its efficacy and safety in carotid atherosclerosis.

The literature were retrieved in online databases. Carotid intima-media thickness (IMT), plaque size, Crouse score, National Institute of Health Stroke Scale (NIHSS), circulating biomarkers, and drug-related adverse events were extracted and compared between the butylphthalide group and the control group without butylphthalide.

Nine randomized controlled trials with 892 subjects were included. Compared with the control group, butylphthalide significantly reduced carotid IMT (MD -0.24 mm, 95% CI [-0.31, −0.16], P < 0.00001), plaque size (MD -3.83 mm2, 95% CI [-5.64, −2.01], P < 0.0001), Crouse score (MD -0.48, 95% CI [-0.89, −0.08], P = 0.02), hs-CRP (MD -1.65 mg/L, 95% CI [-2.99, −0.30], P = 0.02) and MMP-9 (MD -12.29 μg/L, 95% CI [-16.24, −8.33], P < 0.00001). Neurological improvement (NIHSS reduction: MD -2.94, 95% CI [-4.15, −1.73], P < 0.00001) and comparable safety profiles (OR 0.93, 95% CI [0.37, 2.37], P = 0.89) were observed.

Butylphthalide treatment reduces carotid plaque burden, improves neurological recovery and has a high safety profile, supporting its role in stroke prevention.