College of Nursing, Hebi Polytechnic, Henan, China.
College of Health Care, Sehan University, Yeongam, South Korea.
Adv Clin Exp Med. 2024 Nov;33(11):1179-1187. doi: 10.17219/acem/176051.
Alzheimer's disease (AD) affects millions of people worldwide. The most commonly used drugs are acetylcholinesterase inhibitors, i.e., donepezil, galantamine and rivastigmine, which increase levels of acetylcholine. However, the exact efficacy and safety of acetylcholinesterase inhibitors in the treatment of AD is still unclear. The main objective of the current study was to determine the exact safety and efficacy profile of acetylcholinesterase inhibitors in the treatment of AD by conducting a systematic review and meta-analysis of clinical trials according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a web-based literature search of PubMed and clinical trial websites using relevant keywords. Data were extracted from eligible records and pooled as mean difference (MD) or risk ratio (RR) values with their 95% confidence interval (95% CI) using Review Manager software (v. 5.3 for Windows). Heterogeneity was calculated using χ2 and I2 tests. The standard mean difference (SMD) was -0.33 [-0.52, -0.13] for donepezil, -0.48 [-0.58, -0.38] for galantamine and -0.65 [-1.06, -0.23] for rivastigmine, indicating a significant effect of these drugs on cognitive outcomes. Here we show the significant effects of all available acetylcholinesterase inhibitors on cognitive function in patients with AD. However, further studies are needed to draw valid conclusions about the effects of acetylcholinesterase inhibitors on functional outcomes and adverse events.
阿尔茨海默病（AD）影响着全球数以百万计的人。目前最常用的药物是乙酰胆碱酯酶抑制剂，如多奈哌齐、加兰他敏和利伐斯的明，它们可以增加乙酰胆碱的水平。然而，乙酰胆碱酯酶抑制剂治疗 AD 的确切疗效和安全性仍不清楚。本研究的主要目的是通过根据系统评价和荟萃分析的首选报告项目（PRISMA）指南对临床试验进行系统评价和荟萃分析，确定乙酰胆碱酯酶抑制剂治疗 AD 的确切安全性和疗效概况。我们使用相关关键词在 PubMed 和临床试验网站上进行了网络文献检索。从合格记录中提取数据，并使用 Review Manager 软件（用于 Windows 的版本 5.3）以均数差（MD）或风险比（RR）值及其 95%置信区间（95%CI）进行汇总。使用 χ2 和 I2 检验计算异质性。多奈哌齐的标准均数差（SMD）为-0.33[-0.52，-0.13]，加兰他敏为-0.48[-0.58，-0.38]，利伐斯的明为-0.65[-1.06，-0.23]，表明这些药物对认知结局有显著影响。在这里，我们显示了所有可用的乙酰胆碱酯酶抑制剂对 AD 患者认知功能的显著影响。然而，需要进一步的研究来得出关于乙酰胆碱酯酶抑制剂对功能结局和不良事件影响的有效结论。
