Cao Weili, Zhu Bo, Liu Zhiqin, Jia Xiaotao, Zhao Hongwei, Gu Naibing, Chang Hongye, Xi Jing, Li Rong, Guo Kun, Shen Jia, Ding Le, Sun Fanya, Di Zhengli
Department of Neurology, Xi 'an Central Hospital Affiliated to Xi 'an Jiaotong University, No.161 Xiwu Road, Xincheng District, Xi 'an City, Shaanxi Province, PR China.
Department of Neurology, Xi 'an Central Hospital Affiliated to Xi 'an Jiaotong University, No.161 Xiwu Road, Xincheng District, Xi 'an City, Shaanxi Province, PR China.
Neuroscience. 2025 Jan 26;565:29-39. doi: 10.1016/j.neuroscience.2024.11.029. Epub 2024 Nov 15.
The recent emergence of updated drugs for the treatment of Alzheimer's disease (AD) has produced encouraging cognitive and clinical results in clinical trials, but there is still controversy over how to choose effective treatment options among these numerous drugs. The purpose of this network meta-analysis (NMA) is to compare and rank these drugs based on their efficacy.
We systematically searched in PubMed, Web of Science databases and Cochrane LIbrary, gov for randomized controlled trials for data from 2020 to 2024, and then performed a random-effect network meta-analysis.
Our NMA results showed that in several main indicators ADAS-cog, CDR-SB and ADCS-ADL. GV-971 (MD -2.36, 95 % CI -5.08, 0.35), Lecanemab (MD -2.00, 95 % CI -5.25, 1.26), Donanemab (MD -1.45, 95 % CI -4.70, 1.81), Masupirdine (MD -0.83, 95 % CI -3.49, 1.84) were more effective than placebo in improving ADAS-cog. In terms of CDR-SB, Lecanemab (MD -3.11,95 % CI -5.23, -0.99) was more effective. Compared with placebo, Donanemab was more effective in ADCS-ADL (MD 3.26,95 % CI 1.48,5.05). SUCRA values showed that GV-971 (76.1 % and 68.7 %) could achieve better therapeutic effects in ADAS-cog) and NPI, and Lecanema (98.1 %) was more effective in improving CDR-SB scores than other drugs. Donanemab (99.8 %) may be the most promising way to slow down the decline in ADCS-ADL scores. The effect of Masupirdine (80.7 %) on MMSE was significantly better than that of several other drugs.
Donanemab and Lecanemab showed good efficacy in ADCS-ADL and CDR-SB, respectively. GV-971 is the best choice to improve ADAS cogs and NPI.
近期用于治疗阿尔茨海默病（AD）的新型药物在临床试验中取得了令人鼓舞的认知和临床效果，但在众多药物中如何选择有效治疗方案仍存在争议。本网状Meta分析（NMA）的目的是根据疗效对这些药物进行比较和排序。
我们系统检索了PubMed、Web of Science数据库和Cochrane图书馆、gov中2020年至2024年的随机对照试验数据，然后进行随机效应网状Meta分析。
我们的NMA结果显示，在几个主要指标ADAS-cog、CDR-SB和ADCS-ADL方面。GV-971（MD -2.36，95%CI -5.08，0.35）、Lecanemab（MD -2.00，95%CI -5.25，1.26）、Donanemab（MD -1.45，95%CI -4.70，1.81）、Masupirdine（MD -0.83，95%CI -3.49，1.84）在改善ADAS-cog方面比安慰剂更有效。在CDR-SB方面，Lecanemab（MD -3.11，95%CI -5.23，-0.99）更有效。与安慰剂相比，Donanemab在ADCS-ADL方面更有效（MD 3.26，95%CI 1.48，5.05）。SUCRA值显示，GV-971（76.1%和68.7%）在ADAS-cog和NPI方面可取得更好的治疗效果，而Lecanema（98.1%）在改善CDR-SB评分方面比其他药物更有效。Donanemab（99.8%）可能是减缓ADCS-ADL评分下降最有前景的方法。Masupirdine（80.7%）对MMSE的影响明显优于其他几种药物。
Donanemab和Lecanemab分别在ADCS-ADL和CDR-SB方面显示出良好疗效。GV-971是改善ADAS-cogs和NPI的最佳选择。
