Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis.

IF 1.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Medicine Pub Date : 2024-09-20 DOI:10.1097/MD.0000000000039753

Xiaoyan Deng, Daishun Li

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Abstract

Background: To analyze and compare the pharmacological treatments for Alzheimer disease (AD), we will conduct a systematic review and network meta-analysis focusing on their efficacy and safety over a duration exceeding 1 year.

Methods: We searched the databases of PubMed, Scopus, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and CNKI until July 30, 2023, for randomized controlled trials (RCTs) evaluating pharmacological treatments for AD.

Results: Seventeen RCTs, comprising 7214 participants, investigated the efficacy of the following drugs: Donepezil, Rivastigmine, Galantamine, Memantine, Ginkgo biloba extract (EGb), Atorvastatin-calcium and Vitamin B in the treatment of AD. The network meta-analysis resulted indicated that placebo demonstrated greater effectiveness compared to Atorvastatin-calcium 80 mg (mean different [MD] = -6.93, confidence interval [CI] -11.57, -2.29) and Rivastigmine 12 mg (MD = -3.33, CI -6.56, -0.09). EGb120 mg exhibited a greater improvement in cognition compared to Atorvastatin-calcium 80 mg (MD = 7.77, CI 2.07, 13.46) and Rivastigmine 12 mg + EGb120 mg (MD = 9.92, CI 1.32, 17.22). EGb 120 mg emerged as the most efficient intervention for cognition, while placebo demonstrated the least harm over a period exceeding 1 year.

Conclusions: In this network meta-analysis of studies of patients with AD and a follow-up period of at least 1 year, EGb 120 mg demonstrated cognitive benefits, while placebo posed the least harm for AD. More RCTs are required to address the uncertainty surrounding the efficacy of medication.

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长期药物治疗对阿尔茨海默病的影响：系统综述和网络荟萃分析。

背景：为了分析和比较阿尔茨海默病（AD）的药物治疗，我们将进行一项系统性综述和网络荟萃分析，重点关注其超过1年的疗效和安全性：截至 2023 年 7 月 30 日，我们在 PubMed、Scopus、EMBASE、Web of Science、Cochrane Central Register of Controlled Trials 和 CNKI 等数据库中检索了评估药物治疗 AD 的随机对照试验（RCT）：17项随机对照试验共有7214名参与者，研究了以下药物的疗效：多奈哌齐、利伐斯的明、加兰他敏、美金刚、银杏叶提取物（EGb）、阿托伐他汀-钙和维生素B治疗AD的疗效。网络荟萃分析结果表明，与阿托伐他汀钙80毫克（平均差异[MD]=-6.93，置信区间[CI]-11.57，-2.29）和利伐斯敏12毫克（MD=-3.33，CI-6.56，-0.09）相比，安慰剂的疗效更高。与阿托伐他汀-钙 80 毫克（MD = 7.77，CI 2.07，13.46）和利伐斯敏 12 毫克 + EGb120 毫克（MD = 9.92，CI 1.32，17.22）相比，EGb120 毫克对认知能力的改善更大。EGb 120 毫克是对认知最有效的干预措施，而安慰剂在超过 1 年的时间内对认知的伤害最小：在这项针对AD患者和随访期至少1年的研究的网络荟萃分析中，EGb 120毫克对认知能力有益，而安慰剂对AD的危害最小。要解决药物疗效的不确定性，还需要进行更多的研究性试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicine 医学-医学：内科

CiteScore

2.80

自引率

0.00%

发文量

4342

审稿时长

>12 weeks

期刊介绍： Medicine is now a fully open access journal, providing authors with a distinctive new service offering continuous publication of original research across a broad spectrum of medical scientific disciplines and sub-specialties. As an open access title, Medicine will continue to provide authors with an established, trusted platform for the publication of their work. To ensure the ongoing quality of Medicine’s content, the peer-review process will only accept content that is scientifically, technically and ethically sound, and in compliance with standard reporting guidelines.