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  • WJPPS: SEPTEMBER ISSUE PUBLISHED
  • SEPTEMBER 2021 Issue has been successfully launched on 1 September 2021.

Abstract

EVALUATION OF DRUG TREATMENT OPTIONS FOR ALZHEIMER'S DISEASE - A REVIEW OF EARLIER STUDIES

K. Sri Gouri*, K. J. S. Dani* and K. P. R. Chowdary

ABSTRACT

Therapeutic treatments for Alzheimer's disease include the cholinesterase inhibitors donepezil, galantamine and rivastigmine. A review of the evidence by searching MEDLINE, Embase, The Cochrane Library and the International Pharmaceutical Abstracts from 1980 through 2007 (July) for placebo-controlled and comparative trials assessing cognition, function, behavior, global change and safety was made. Thirty-three articles on 26 studies were included in the review. Meta-analyses of placebo-controlled data support the drugs modest overall benefits for stabilizing or slowing decline in cognition, function, behavior and clinical global change. Three open-label trials and one double-blind randomized trial directly compared donepezil with galantamine and rivastigmine. Results are conflicting: two studies suggest no differences in efficacy between compared drugs, while one study found donepezil to be more efficacious than galantamine and one study found rivastigmine to be more efficacious than donepezil. Adjusted indirect comparison of placebo-controlled data did not find statistically significant differences among drugs with regard to cognition, but found the relative risk of global response to be better with donepezil and rivastigmine compared with galantamine. Indirect comparisons also favored donepezil over galantamine with regard to behavior, Across trials, the incidence of adverse events was generally lowest for donepezil and highest for rivastigmine. These studies are discussed in this presentation.

Keywords: Alzheimer's disease, Evaluation of drug treatments, Review of studies.


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