Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, P. R. China.
Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, Toronto, Canada.
Diabetes Obes Metab. 2018 Oct;20(10):2467-2471. doi: 10.1111/dom.13373. Epub 2018 Jun 19.
This study (registered with PROSPERO, CRD42018085967) compares the efficacy (i.e. pro-cognitive effects) and acceptability of antidiabetic agents for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Cochrane Library (CENTRAL), PubMed/MEDLINE, EMBASE and PsycINFO were searched from inception to January 15, 2018 for randomized controlled trials comparing antidiabetic agents with placebo and/or another active antidiabetic agent for the treatment of AD or MCI. Nineteen eligible studies (n = 4855) evaluating the effects of 6 different antidiabetic drugs (i.e. intranasal insulin, pioglitazone, rosiglitazone, metformin, sitagliptin and liraglutide) were included. The results of 29 pairwise comparisons indicated that cognition was significantly improved in subjects treated with antidiabetic agents compared with placebo. Pioglitazone 15 to 30 mg demonstrated the greatest efficacy compared to placebo in network meta-analysis. No significant differences in acceptability were identified when comparing agents with each other and with placebo. The current findings indicate a pro-cognitive class effect of antidiabetic agents in AD/MCI. Other antidiabetic agents should also be investigated in future studies.
这项研究（在 PROSPERO 上注册，CRD42018085967）比较了抗糖尿病药物治疗阿尔茨海默病（AD）和轻度认知障碍（MCI）的疗效（即促认知作用）和可接受性。从成立到 2018 年 1 月 15 日，我们在 Cochrane Library（CENTRAL）、PubMed/MEDLINE、EMBASE 和 PsycINFO 中搜索了比较抗糖尿病药物与安慰剂和/或另一种活性抗糖尿病药物治疗 AD 或 MCI 的随机对照试验。纳入了 19 项符合条件的研究（n=4855），评估了 6 种不同抗糖尿病药物（即鼻内胰岛素、吡格列酮、罗格列酮、二甲双胍、西他列汀和利拉鲁肽）的效果。29 项两两比较的结果表明，与安慰剂相比，接受抗糖尿病药物治疗的患者认知功能显著改善。网络荟萃分析显示，吡格列酮 15 至 30 毫克与安慰剂相比疗效最佳。在相互比较和与安慰剂比较时，未发现可接受性的显著差异。目前的研究结果表明，抗糖尿病药物在 AD/MCI 中有促认知的作用。其他抗糖尿病药物也应在未来的研究中进行探讨。
