In brief, these reviews either did not include relevant RCTs that were available at the time when their review was conducted [ Blanco-Silvente L, Castells X, Saez M, Barceló MA, Garre-Olmo J, Vilalta-Franch J, et al.Discontinuation, Efficacy, and Safety of Cholinesterase Inhibitors for Alzheimer’s Disease: a Meta-Analysis and Meta-Regression of 43 Randomized Clinical Trials Enrolling 16 106 Patients. We defined the PICO question (eligible population, intervention, comparator and outcomes) and the relevance of the different outcomes according to GRADE in conjunction with clinical experts while taking into consideration feedback from a stakeholder process. 2008;5(1):83–9. Large pragmatic RCTs with long-term follow-up and focus on functional outcomes, delay in nursing home placement and adverse events are needed. Porsteinsson AP, Grossberg GT, Mintzer J, Olin JT; Memantine MEM-MD-12 Study Group. The treatment approach of inhibiting peripheral AchE for myasthenia gravis had effectively proven that AchE inhibition was a reachable therapeutic target. Trials with promising new agents (idalopirdine or intepirdine) have been stopped prematurely because of lack of benefit [ This includes donepezil, galanthamine and rivastigmine. D.G., V.G., H.R., R.W.K, M.S., K.A.M., Z.A., H.C.B. 18. In contrast to the practice in other countries, the Swiss mandatory basic health insurance does not cover the combination therapy [ Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.King MT. Dementia.

doi:. 2006;14(5):428–37. Since we did not expect patients to be AChEI treatment naïve, we set no restriction regarding precedent or ongoing AChEI or memantine treatment. Supplement 2 – Hierarchy of extraction of eligible instruments or further explanations However, the authors did not report whether any patients who completed the trial were placed in a nursing home. Secondary Dementia and DSM-5: Changes, Cost, and Confusion 2012. WHO World Health Organization. Monsch AU, Büla C, Hermelink M, Kressig RW, Martensson B, Mosimann U, et al., Alzheimer Forum Schweiz. 2009;146(3):238–44. The clinical efficacy and safety of combination therapy with acetylcholinesterase inhibitor (AChEI) and memantine compared to AChEI or memantine alone in patients with Alzheimer’s disease is inconclusive. This review describes historical aspects and the vast range of use of cholinesterase inhibitors in traditional societies and industrial nations. eCollection 2019.Exp Ther Med. Cholinesterasehemmer bei Alzheimer Demenz: Ergänzungsauftrag Rivastigmin-Pflaster und Galantamin.

Alzheimer Dis Assoc Disord. At short- and long-term follow-up, there were no significant differences for cognition (short follow-up: MD 1.32, 95% CI −0.44 to 3.08, I In most of the included trials, memantine was added to ongoing AChEI therapy, which is in line with the standard treatment course. and Y.T. doi:. Yoon SJ, Choi SH, Na HR, et al.Effects on agitation with rivastigmine patch monotherapy and combination therapy with memantine in mild to moderate Alzheimer’s disease: a multicenter 24-week prospective randomized open-label study (the Korean EXelon Patch and combination with mEmantine Comparative Trial study). J Am Geriatr Soc. At short-term follow-up, the RR for experiencing at least one adverse event (RR 1.05, 95% CI 0.98 to 1.12, I 2013;25(6):919–27. 2017;3(3):367–84. Zheng Y, Yu J. Araki 2014, DOMINO-AD 2012, Herrmann 2013, Grossberg 2013, Porsteinsson 2008 and Tariot 2004 reported that patients were on AChEI therapy for at least 3 months. Future researchers should consider conducting an individual patient data (IPD) meta-analysis, which would allow them (1) to perform post-hoc responder analyses based on MCIDs, which still need to be established, (2) to use accurate imputation methods (instead of LOCF) and (3) to assess heterogeneity among trials with subgroups analyses. A point of minimal important difference (MID): a critique of terminology and methods. has worked on projects in the last three years for the Swiss Medical Board, Bayer, and Grünenthal for which the respective institutes received funding.

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