Background: Stroke is a significant cause of morbidity and mortality worldwide, with cerebral edema being a major complication. Glibenclamide, a SUR1-TRPM4 channel inhibitor, has been proposed to reduce cerebral edema, but its clinical efficacy remains uncertain. This meta-analysis aimed to evaluate the efficacy and safety of glibenclamide in patients with stroke, including acute ischemic stroke, acute subarachnoid hemorrhage, and intracerebral hemorrhage. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus up to January 2025. The primary efficacy outcomes included excellent (modified Rankin Scale [mRS] score 0–1) and good (mRS score 0–2) functional outcomes at 90 days. Safety outcomes included the incidence of hypoglycemia and decompressive craniectomy. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: Ten and eight randomized controlled trials (RCTs) were included in our qualitative and quantitative analysis, respectively, encompassing 1,691 participants aged 18 to 85. No significant difference was observed between the glibenclamide and control groups regarding excellent functional outcome (risk ratio [RR] 1.10, 95% confidence interval [CI] 0.92–1.32, P = 0.29) and good functional outcome (RR 1.07, 95% CI 0.96–1.18, P = 0.22). Safety analysis revealed no significant increase in serious adverse events (RR 1.11, 95% CI 1.00–1.23, P = 0.06). Notably, hypoglycemia incidence after sensitivity analysis was higher in the glibenclamide group (RR 4.56, 95% CI 2.07–10.03, P = 0.0002). Conclusions: Glibenclamide did not significantly improve functional outcomes or reduce mortality in stroke patients but was associated with a higher incidence of hypoglycemia. Further well-designed RCTs are needed to clarify its therapeutic role and optimize safety protocols. Clinical trial registration : PROSPERO registration number: CRD420251008350.

Purpose: Lynch syndrome patients are at a high risk for developing colorectal cancer; thus, optimal surveillance strategies are required. Although colonoscopic imaging methods differ in diagnostic performance, direct comparisons in this population are not very common. We aimed to evaluate and compare the detection capabilities of white-light endoscopy (WLE), chromoendoscopy, virtual chromoendoscopy (NBI: narrow band imaging, LCI: linked color imaging, I-SCAN), and AI-assisted colonoscopy in detecting neoplastic and non-neoplastic lesions in individuals diagnosed with Lynch syndrome. Methods: Up until March 2025, PubMed, WOS, and Scopus were searched. Relevant studies included observational or interventional designs that contrasted various forms of colonoscopy in adults with Lynch syndrome. The primary outcomes were the lesion detection rate and number of lesions per colonoscopy. Secondary outcomes included total procedure time and withdrawal time. Credibility of the evidence was assessed employing CINeMA. Results: Nine studies were included. LCI and chromoendoscopy demonstrated a significantly higher neoplastic lesion detection rate compared to WLE (RD 0.11, 95% CI [0.01, 0.21], P = 0.03) and (RD 0.07, 95% CI [0.01, 0.14], P = 0.03), respectively, and LCI significantly detected more lesions per procedure (MD = 0.23, 95% CI 0.01–0.45, P = 0.04). Chromoendoscopy was better at marking the non-neoplastic lesions (RD 0.16, 95% CI [0.05, 0.27], P = 0.005) but had the longest procedure and withdrawal times. AI-assisted, as well as virtual ones, were better than WLE but were not as effective as LCI or chromoendoscopy. Conclusion: In terms of efficiency, LCI and chromoendoscopy improved WLE in detecting neoplastic lesions in Lynch syndrome. Chromoendoscopy remains valuable for non-neoplastic detection, but procedural time is a major drawback. AI-assisted technologies are promising, which require additional investigation.

Purpose: Homozygous Familial Hypercholesterolemia (HoFH) is a rare and life-threatening genetic disorder characterized by elevated low-density lipoprotein cholesterol (LDL-C) and early-onset atherosclerotic cardiovascular disease. Lomitapide, a microsomal triglyceride transfer protein (MTP) inhibitor, decreases LDL-C independent of LDL receptor function, providing an alternative treatment in this population. We aimed to evaluate the efficacy and safety of lomitapide in patients with HoFH through a systematic review and meta-analysis of available clinical evidence. Methods: A comprehensive search was conducted in PubMed, Scopus, and Web of Science through March 2025. Observational studies and clinical trials reporting on lipid profile changes and safety outcomes in HoFH patients receiving lomitapide were included. Outcomes were pooled using random-effects models, and heterogeneity was assessed using the I ² statistic. Results: Eight studies comprising both adult and pediatric patients (n = 209) were included. Lomitapide significantly reduced LDL-C levels by 49.27%, total cholesterol by 46.05%, and apolipoprotein B by 51.01%. Reductions were also observed in triglycerides, VLDL-C, and non–HDL-C. HDL-C remained relatively unchanged. Adverse events were mostly gastrointestinal, with a 14% discontinuation rate. The overall quality of studies ranged from fair to good. Conclusions: Lomitapide demonstrates substantial efficacy in reducing LDL-C and other atherogenic lipids in HoFH patients, with an acceptable safety profile. These findings support its role as an adjunctive therapy in this population, though further randomized controlled trials are warranted to validate long-term safety and effectiveness.