美金刚胺对阿尔茨海默氏症:一个更新的系统回顾和荟萃分析。

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岸T, Matsunaga年代,欧雅K,野村我Ikuta T,岩田聪N

美金刚胺对阿尔茨海默氏症:一个更新的系统回顾和荟萃分析。

60 J老年痴呆症说。2017;(2):401 - 425。doi: 10.3233 / jad - 170424。

PubMed ID

28922160 (在PubMed

]

文摘

背景:美金刚胺的临床效益阿尔茨海默病(AD)仍然是不确定的。目的:我们进行了一个更新的系统回顾和荟萃分析的有效性/安全性美金刚胺的广告。方法:我们包括美金刚胺为AD患者的随机试验。认知功能评分(CF)、行为障碍得分(BD),和所有原因中止被用作主要的措施。基于随机模型的效果评估的荟萃分析。研究结果:30 (n = 7567;美金刚胺与安慰剂:N = 11, N = 3298;美金刚胺+胆碱酯酶抑制剂(M + ChEIs)与ChEIs: N = 17, N = 4175)。美金刚胺表现出显著提高CF(标准平均差(SMD) = -0.24, 95%置信区间(CIs) 95% = -0.34, -0.15, p < 0.00001, I2 = 35%)和BD (SMD = -0.16, 95% CIs = -0.29, -0.04, p = 0.01, I2 = 52%)与安慰剂相比。敏感性分析包括患者只有moderate-severe广告,美金刚胺优于安慰剂在减少BD没有相当大的异质性(SMD = -0.20, 95% CIs = -0.34, -0.07, p = 0.003, I2 = 36%)。 Compared with ChEIs, M+ChEIs showed a greater reduction in BD (SMD = -0.20, 95% CIs = -0.36, -0.03, p = 0.02, I2 = 77%) and a trend of CF improvement (SMD = -0.11, 95% CIs = -0.22, 0.01, p = 0.06, I2 = 56%). However, in the sensitivity analysis of double-blind, placebo-controlled studies only, M+ChEIs showed a significant reduction in BD compared with ChEIs without considerable heterogeneity (SMD = -0.11, 95% CIs = -0.21, -0.01, p = 0.04, I2 = 40%). When performing the sensitivity analysis of donepezil studies only, M+ChEIs was superior to ChEIs in improving CF without considerable heterogeneity (SMD = -0.18, 95% CIs = -0.31, -0.05, p = 0.006, I2 = 49%). No differences were detected in all-cause discontinuation between the groups. CONCLUSIONS: The meta-analyses suggest the credible efficacy and safety of memantine in treating AD when used alone or in combination with ChEIs.

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美金刚胺