JOURNAL ARTICLE

Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease

Craig W Ritchie, David Ames, Tim Clayton, Rosalind Lai
American Journal of Geriatric Psychiatry 2004, 12 (4): 358-69
15249273
The authors estimated the effects of each of the three commonly used drugs for Alzheimer disease (donepezil, galantamine, and rivastigmine) in terms of predefined clinical outcomes and trial completion rates, by dosing level, and described differences among them. Using both electronic and manual search strategies (January 1992 to July 2002), a metaanalysis examined the effect of the drugs on clinical outcomes and completion rates. Regression analyses compared the effect of dose on clinical outcomes and completion rates, using 10 donepezil, 6 galantamine, and 5 rivastigmine articles. All three drugs showed beneficial effects on cognitive tests, as compared with placebo. For donepezil and rivastigmine, larger doses were associated with larger effect. This was not the case with galantamine. The odds of clinical global improvement demonstrated superiority over placebo for each drug, with no dose effects noted. Dropout rates were greater with galantamine and rivastigmine. There was little difference in dropout rate for each drug at each dose-level, except with high-dose donepezil. This was accounted for by the high dropout rate in two 52-week studies using larger doses. In summary, all three drugs had similar cognitive efficacy, with donepezil and rivastigmine showing a dose effect across the dosing levels studied. However, both galantamine and rivastigmine were associated with a greater risk of trial dropout than placebo, especially at higher dosing levels.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
15249273
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"