Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis
BackgroundPharmacological treatments play a significant role in treating mild to moderate Alzheimer’s disease (AD), but the optimal doses of various drugs used for these treatments are unknown. Our study compared the efficacy, acceptability, and safety of different doses of pharmacological treatment...
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2020.00778/full |
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| author | Tingting Zhang Nanyang Liu Hongfu Cao Wei Wei Lina Ma Hao Li |
| author_facet | Tingting Zhang Nanyang Liu Hongfu Cao Wei Wei Lina Ma Hao Li |
| author_sort | Tingting Zhang |
| collection | DOAJ |
| description | BackgroundPharmacological treatments play a significant role in treating mild to moderate Alzheimer’s disease (AD), but the optimal doses of various drugs used for these treatments are unknown. Our study compared the efficacy, acceptability, and safety of different doses of pharmacological treatments for mild to moderate AD.MethodsRandomized controlled trials (RCTs) were identified by searching the PubMed, EMBASE, and Cochrane Library databases (all RCTs published from the date of inception of the databases until September 19, 2019). Trials comparing the efficacy, acceptability, and safety of pharmacological interventions involving donepezil, galantamine, rivastigmine, memantine, huperzine A, and Ginkgo biloba extract EGb761, alone or in combination, were identified. The primary outcomes were efficacy, acceptability, and safety.ResultsOur meta-analysis included 37 studies involving 14,705 participants. In terms of improving cognitive function, galantamine 32 mg, galantamine 24 mg, donepezil 5 mg, and donepezil 10 mg were more effective than other interventions, with the surface under the cumulative ranking curve (SUCRA) values of 93.2, 75.5, 73.3, and 65.6%, respectively. According to the SUCRA values, EGb761 240 mg was considered to be the optimal intervention in terms of both acceptability and safety. With regard to clinical global impression, rivastigmine 12 mg had the highest probability of being ranked first (83.7%). The rivastigmine 15 cm2 patch (SUCRA = 93.7%) may be the best choice for daily living. However, there were no interventions that could significantly improve neuropsychiatric symptoms, compared with the placebo.ConclusionsDifferent doses of the tested pharmacological interventions yielded benefits with regard to cognition, acceptability, safety, function, and clinical global impressions, but not effective behaviors. |
| first_indexed | 2024-12-21T20:21:04Z |
| format | Article |
| id | doaj.art-a87202555fd84ae5ad726f05937958d1 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-21T20:21:04Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-a87202555fd84ae5ad726f05937958d12022-12-21T18:51:29ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122020-05-011110.3389/fphar.2020.00778529266Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-AnalysisTingting Zhang0Nanyang Liu1Hongfu Cao2Wei Wei3Lina Ma4Hao Li5College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Geratology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaInstitute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Science, Beijing, ChinaCollege of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Geratology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaDepartment of Geratology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, ChinaBackgroundPharmacological treatments play a significant role in treating mild to moderate Alzheimer’s disease (AD), but the optimal doses of various drugs used for these treatments are unknown. Our study compared the efficacy, acceptability, and safety of different doses of pharmacological treatments for mild to moderate AD.MethodsRandomized controlled trials (RCTs) were identified by searching the PubMed, EMBASE, and Cochrane Library databases (all RCTs published from the date of inception of the databases until September 19, 2019). Trials comparing the efficacy, acceptability, and safety of pharmacological interventions involving donepezil, galantamine, rivastigmine, memantine, huperzine A, and Ginkgo biloba extract EGb761, alone or in combination, were identified. The primary outcomes were efficacy, acceptability, and safety.ResultsOur meta-analysis included 37 studies involving 14,705 participants. In terms of improving cognitive function, galantamine 32 mg, galantamine 24 mg, donepezil 5 mg, and donepezil 10 mg were more effective than other interventions, with the surface under the cumulative ranking curve (SUCRA) values of 93.2, 75.5, 73.3, and 65.6%, respectively. According to the SUCRA values, EGb761 240 mg was considered to be the optimal intervention in terms of both acceptability and safety. With regard to clinical global impression, rivastigmine 12 mg had the highest probability of being ranked first (83.7%). The rivastigmine 15 cm2 patch (SUCRA = 93.7%) may be the best choice for daily living. However, there were no interventions that could significantly improve neuropsychiatric symptoms, compared with the placebo.ConclusionsDifferent doses of the tested pharmacological interventions yielded benefits with regard to cognition, acceptability, safety, function, and clinical global impressions, but not effective behaviors.https://www.frontiersin.org/article/10.3389/fphar.2020.00778/fullAlzheimer’s diseasedonepezilnetwork meta-analysispharmacological treatmentrandomized controlled trial |
| spellingShingle | Tingting Zhang Nanyang Liu Hongfu Cao Wei Wei Lina Ma Hao Li Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis Frontiers in Pharmacology Alzheimer’s disease donepezil network meta-analysis pharmacological treatment randomized controlled trial |
| title | Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis |
| title_full | Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis |
| title_fullStr | Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis |
| title_full_unstemmed | Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis |
| title_short | Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer’s Disease: A Bayesian Network Meta-Analysis |
| title_sort | different doses of pharmacological treatments for mild to moderate alzheimer s disease a bayesian network meta analysis |
| topic | Alzheimer’s disease donepezil network meta-analysis pharmacological treatment randomized controlled trial |
| url | https://www.frontiersin.org/article/10.3389/fphar.2020.00778/full |
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