Efficacy and safety of galantamine treatment for patients with Alzheimer’s disease: a meta-analysis of randomized controlled trials

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• 作者：Deqi Jiang ; Xiujuan Yang ; Mingxing Li ; Yan Wang…
• 关键词：Alzheimer’s disease ; Galantamine ; Efficacy ; Safety ; Meta ; analysis
• 刊名：Journal of Neural Transmission
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：122
• 期：8
• 页码：1157-1166
• 全文大小：2,234 KB
• 参考文献：Alzheimer’s Association (2010) 2010 Alzheimer’s disease facts and figures. Alzheimer’s Dement J Alzheimer’s Assoc 6(2):158View Article
  American Psychological Association (1994) Diagnostic and statistical manual of mental disorders: DSM-IV. American Psychiatric Association
  Birks J (2012) Cholinesterase inhibitors for Alzheimer’s disease (Review)
  Bora E, Veznedaroglu B, Kayahan B (2005) The effect of galantamine added to clozapine on cognition of five patients with schizophrenia. Clin Neuropharmacol 28(3):139-41PubMed View Article
  Brodaty H, Corey-Bloom J, Potocnik FC, Truyen L, Gold M, Damaraju CRV (2005) Galantamine prolonged-release formulation in the treatment of mild to moderate Alzheimer’s disease. Dement Geriatr Cogn Disord 20(2-):120-32PubMed View Article
  Burns A, Bernabei R, Bullock R, Jentoft AJC, Fr?lich L, Hock C, Raivio M, Triau E, Vandewoude M, Wimo A (2009) Safety and efficacy of galantamine (Reminyl) in severe Alzheimer’s disease (the SERAD study): a randomised, placebo-controlled, double-blind trial. Lancet Neurol 8(1):39-7PubMed View Article
  Cochran WG (1954) The combination of estimates from different experiments. Biometrics 10(1):101-29View Article
  Gao HZ, Chen Y, Wei Y (2012) Clinical observation on the effect of galantamine in the treatment of mild cognitive impairment. Hainan Medical Journal 23(3):38-9
  Hager K, Baseman AS, Nye JS, Brashear HR, Han J, Sano M, Davis B, Richards HM (2014) Effects of galantamine in a 2-year, randomized, placebo-controlled study in Alzheimer’s disease. Neuropsychiatr Dis Treat 10:391-01. doi:10.-147/?ndt.?s57909 PubMed Central PubMed
  Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539-558. doi:10.-002/?sim.-186 PubMed View Article
  Higgins J, Altman DG, G?tzsche PC, Jüni P, Moher D, Oxman AD, Savovi? J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928.?doi:10.-136/?bmj.?d5928 PubMed Central PubMed View Article
  Hohnadel E, Bouchard K, Terry AV Jr (2007) Galantamine and donepezil attenuate pharmacologically induced deficits in prepulse inhibition in rats. Neuropharmacology 52(2):542-51PubMed Central PubMed View Article
  Hong X, Zhang ZX, Wang LN, Shao FY, Xiao SF, Wang YH, Qian CY, Shu L, Chen SD, Xu XH (2006) A randomized study comparing the effect and safety of galantamine and donepezil in patients with mild to moderate Alzheimer, s disease. Chin J Neurol 39(6):379-82
  Inestrosa NC, Sagal JP, Colombres M (2005) Acetylcholinesterase interaction with Alzheimer amyloid β. In: Alzheimer’s disease. Springer?US, New York, pp 299-17
  Liu FG, Gao ZX, Chen MJ, Ma YX, Shao FY, Zhang GQ, Qu ZW (2003) Evaluation of galantamin in treatment of Alzheimer, s disease: a multicenter, randomized, double-blind study. Chin J New Drugs Clin Rem 22(1):29-2
  McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS/ARDA workgroup under the auspices of Department of Health and Human Service Task Force on Alzheimer’s disease. Neurology 34:939-44PubMed View Article
  Popa RV, Pereira EF, Lopes C, Maelicke A, Albuquerque EX (2006) The N-butylcarbamate derivative of galantamine acts as an allosteric potentiating ligand on α7 nicotinic receptors in hippocampal neurons. J Mol Neurosci 30(1):227-32PubMed View Article
  Raskind M, Peskind E, Wessel T, Yuan W (2000) Galantamine in AD A 6-month randomized, placebo-controlled trial with a 6-month extension. Neurology 54(12):2261-268PubMed View Article
  Raskind MA, Peskind ER, Truyen L, Kershaw P, Damaraju CV (2004) The cognitive benefits of galantamine are sustained for at least 36?months: a long-term extension trial. Arch Neurol 61(2):252-56PubMed View Article
  Richarz U, Gaudig M, Rettig K, Schauble B (2014) Galantamine treatment in outpatients with mild Alzheimer’s disease. Acta Neurol Scand 129(6):382-92. doi:10.-111/?ane.-2195 PubMed View Article
  Rockwood K, Mintzer J, Truyen L, Wessel T, Wilkinson D (2001) Effects of a flexible galantamine dose in Alzheimer’s disease: a randomised, controlled trial. J Neurol Neurosurg Psychiatry 71(5):589-95PubMed Central PubMed View Article
  Samochocki M, H?ffle A, Fehrenbacher A, Jostock R, Ludwig J, Christner C, Radina M, Zerlin M, Ullmer C, Pereira EF (2003) Galantamine is an allosterically potentiating ligand of neuronal nicotinic but not of muscarinic acetylcholine receptors. J Pharmacol Exp Ther 305(3):1024-036PubMed View Article
  Sano M, Wilcock GK, van Baelen B, Kavanagh S (2003) The effects of galantamine treatment on caregiver time in Alzheimer’s disease. Int J Geriatr Psychiatry 18(10):942-50PubMed View Article
  Sasaki H (1996) Clinical feature of dementia of the Alzheimer type. Rinsho Byori Jpn J Clin Pathol 44(3):207-12
  Schubert MH, Young KA, Hicks PB (2006) Galantamine improves cogni
• 作者单位：Deqi Jiang (1) (2)
  Xiujuan Yang (1)
  Mingxing Li (1)
  Yan Wang (1)
  Yong Wang (1)
  
  1. Department of Pharmacy, Zhu Jiang Hospital, Southern Medical University, Guangzhou, 510282, People’s Republic of China
  2. Department of Biopharmaceutical, Yulin Normal University, Yulin, 537000, People’s Republic of China
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurology
  Pharmacology and Toxicology
  Psychiatry
  
• 出版者：Springer Wien
• ISSN：1435-1463

文摘

Cholinesterase inhibitors treatment is considered as a common therapeutic approach for Alzheimer’s disease (AD) by numerous reported studies, but the role of currently available drugs for AD is still controversial. Our study aimed to evaluate the efficacy and safety of galantamine for the treatment of AD, and provide the basis and reference for clinical rational drug use. Randomized controlled trials (RCTs) of galantamine for AD published up to April 30, 2014 were searched. A random or fixed-effect model was used to analyze outcomes which were expressed as risk ratios (RRs) or mean difference (MD) with a 95?% confidence interval (CI). Heterogeneity was assessed by Q test and I 2 statistic. The outcome measurements were as follows: the changes of Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog), Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Neuropsychiatric Inventory (NPI), Clinicians-Interview-Based Impression of Change with Caregiver’s Input (CIBIC+), adverse effects and dropouts. Eleven articles with 4,074 participants were included. Administration of galantamine for 8-8?weeks (16-0?mg daily) led to significant improvements in ADAS-cog score [P?<?0.00001, MD?=??.95, 95?% CI (?.32, ?.57)], MMSE score [P?=?0.003, MD?=?2.50, 95?% CI (0.86, 4.15)], NPI score [P?=?0.001, MD?=??.58, 95?% CI (?.54, ?.62)], and CIBIC+ scale [P?<?0.00001, RR?=?1.26, 95?% CI (1.15, 1.39)], but not in ADL score [P?=?0.43, MD?=?0.71, 95?% CI (?.07, 2.48)]. More adverse events and dropouts occurred in the galantamine group than that in the placebo group, the differences were statistically significant (all P?<?0.05). Galantamine could significantly improve cognitive, behavioral, and global performances in patients with AD. In addition, we need to use it with caution in the clinical treatment.