Volume 25, Issue 114, August 2021

Efficacy of Acetazolamide in management of idiopathic intracranial hypertension: A systematic review and meta-analysis

Abdulmajeed Albalawi^1♦, Alanoud Alharbi², Mawaddah Altaleb³, Mohammed Almatrafi³, Shuruq Alzahuf⁴, Omayrah Alanzi¹, Aljawharh Alawad⁴, Asayel Mohammed Bin Saif⁵, Sarah Almuwarraee³, Bader Alotaibi⁶, Faisal Almishali⁷, Tarek Kassem⁸, Fatimah Alrajab⁴, Omar Almatrafi³, Hezam Alshahrani⁹

¹Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia
²King Fahad Specialist Hospital, Buraydah, Qassim, Saudia Arabia
³Faculty of Medicine, Taibah University, Madina, Saudi Arabia
⁴Faculty of Medicine, Najran University, Najran, Saudi Arabia
⁵College of Medicine, Imam Mohammed binSaud Islamic University, Riyadh, Saudi Arabia
⁶Faculty of Medicine, Prince Sattam bin Abdulaziz University (PSAU), AlKharj, Saudi Arabia
⁷College of Medicine, Qassim University, Qassim, Saudi Arabia
⁸Department of Pharmaceuticals & Biomedical Science, California Northstate University College of Pharmacy, California, United States of America
⁹College of Medicine, Bisha University, Bisha, Saudi Arabia

^♦Corresponding author
Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia

ABSTRACT

Objectives: To investigate the efficacy of acetazolamide in the treatment of idiopathic intracranial hypertension. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane central for relevant published clinical trials. We performed the risk of bias using Cochrane’s risk of bias tool. Our outcomes of interest were: SF-36 mental and physical scores, papilledema grade, diplopia, optic nerve head (ONH) volume, and 6-item listed headache impact test (HIT6). We conducted the analysis using OpenMeta Analyst Software and used mean difference (MD) with 95% confidence interval (CI) for analyzing continuous data, while risk ratio (RR) and 95% CI was used for analyzing dichotomous outcomes. Results: We included six clinical trials in our analysis. The results revealed that, compared to baseline, acetazolamide significantly improves the SF-36 physical score (MD=3.54, (95% CI [-2.014%, 9.107%), SF-36 mental score (MD=2.593, (95% CI [-2.238%, 7.424%), reduces papilledema grade (MD=-0.687, (95% CI [-1.795%, 0.420%), and HIT6 score (MD=-5.675, (95% CI [-14.745%, 3.395%). Conclusion: Acetazolamide is an effective medical treatment for idiopathic intracranial hypertension. However, more studies are still required to provide clearer evidence about the drug efficacy and safety.

Keywords: Acetazolamide, idiopathic intracranial hypertension, pseudotumor cerebri.

Medical Science, 2021, 25(114), 1827-1836

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