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Latrepirdine(二甲苯并庚噻嗪,Dimebon)治疗改善认知功能的疗效证据:一项荟萃分析。

Evidence for the efficacy of latrepirdine (Dimebon) treatment for improvement of cognitive function: a meta-analysis.

机构信息

Departamento de Ciencias Médicas, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha (UCLM), Albacete, Spain Servicio de Farmacia, Complejo Hospitalario de Albacete, Albacete, Spain.

出版信息

J Alzheimers Dis. 2014;38(1):155-64. doi: 10.3233/JAD-130872.

Abstract

Over the last few years, latrepirdine, a démodé antihistamine drug, has been proposed to be useful for treating neurodegenerative disorders such as Alzheimer's and Huntington's diseases, and more recently schizophrenia. The mechanisms and pharmacological targets that are responsible for the beneficial effects on neurodegenerative diseases remain unknown. But it has been proposed that latrepirdine may modulate several targets including voltage-gate Ca+2 channels, mitochondrial permeability pore transition, or several neurotransmitter receptors. Herein, we present a meta-analysis of randomized controlled trials to ascertain the efficacy and safety of latrepirdine on cognitive function. By doing a search in electronic databases, we found five clinical trials in which the effect of latrepirdine on cognition function has been studied, and this was evaluated using MMSE, ADAS-cog, ADCS-ADL, and NPI scores. Latrepirdine generally presented a good safety profile; it was well tolerated when given alone or in combination with a variety of other drugs. We observed heterogeneous results between trials; latrepirdine failed to exert a significant beneficial effect although it tended to improve cognitive scores. The only significant benefit that we found was for the NPI score in Alzheimer's disease patients.

摘要

在过去的几年中,一种被淘汰的抗组胺药物——拉替拉嗪,被提议可用于治疗神经退行性疾病,如阿尔茨海默病和亨廷顿病,以及最近的精神分裂症。负责神经退行性疾病的有益作用的机制和药理靶点仍然未知。但有人提出,拉替拉嗪可能调节包括电压门控 Ca+2 通道、线粒体通透性孔过渡或几种神经递质受体在内的几个靶点。在此,我们对随机对照试验进行了荟萃分析,以确定拉替拉嗪对认知功能的疗效和安全性。通过在电子数据库中进行搜索,我们发现了五项研究拉替拉嗪对认知功能影响的临床试验,并用 MMSE、ADAS-cog、ADCS-ADL 和 NPI 评分进行评估。拉替拉嗪通常具有良好的安全性;单独使用或与各种其他药物联合使用时耐受性良好。我们观察到试验之间存在异质性结果;拉替拉嗪虽然有改善认知评分的趋势,但未能产生显著的有益效果。我们发现的唯一显著益处是阿尔茨海默病患者的 NPI 评分。

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