Jiang Jue, Jiang Hong
Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Zhizaoju Road 639, Shanghai, 200011, China,
Neurol Sci. 2015 Sep;36(9):1633-41. doi: 10.1007/s10072-015-2221-2. Epub 2015 Apr 22.
The role of memantine as a treatment for Alzheimer's disease (AD) has been controversial. In clinical trials, a high dropout rate and numerous adverse events associated with memantine have been observed. However, given the relative scarcity of effective treatments for AD it would seem prudent to re-examine existing evidence to determine whether or not memantine should be used. Eight databases were utilized for randomized controlled trials that were published prior to December 31, 2013 and were according with the inclusion criteria. Trial methods, clinical characteristics, outcomes, and adverse events were extracted and analyzed with Review Manager 5.2. We obtained 2293 studies and determined that 13 of those studies met the inclusion criteria. Memantine therapy showed significant benefits to cognition, mental state, activities of daily life, the clinician's global impression in term with MMSE, SIB, NPI, ADCS-ADL19, CIBIC-Plus, respectively. Memantine therapy did not significantly increase the incidence of total adverse events, serious adverse events, death but it did increase the risk for somnolence.
美金刚作为治疗阿尔茨海默病(AD)的药物,其作用一直存在争议。在临床试验中,观察到美金刚的高脱落率以及众多不良事件。然而,鉴于AD有效治疗方法相对稀缺,重新审视现有证据以确定是否应使用美金刚似乎是审慎之举。利用八个数据库检索了2013年12月31日前发表且符合纳入标准的随机对照试验。采用Review Manager 5.2提取并分析试验方法、临床特征、结果及不良事件。我们共获得2293项研究,确定其中13项研究符合纳入标准。美金刚治疗分别在简易精神状态检查表(MMSE)、严重受损量表(SIB)、神经精神问卷(NPI)、阿尔茨海默病协作研究日常生活能力量表(ADCS-ADL19)、临床综合印象量表加分量表(CIBIC-Plus)方面对认知、精神状态、日常生活活动能力、临床医生整体印象显示出显著益处。美金刚治疗并未显著增加总不良事件、严重不良事件及死亡的发生率,但确实增加了嗜睡风险。