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cholinesterase inhibitor clinical trials
- see donepezil clinical trials
- cholinesterase inhibitor clinical trials (review 2005); [1] benefits of cholinesterase inhibitors in Alzheimer disease patients are relatively small & likely extend to only a subset of AD patients that can't be identified in advance [1]
- comment in Journal Watch in connection with [2] 'Cholinesterase inhibitors confer a modest statistical benefit in large, short-term studies. The clinical relevance of this statistical benefit is controversial. A small proportion of patients may derive observable benefits. A therapeutic trial is thus reasonable; however, indefinite therapy without observable benefit is not indicated.'
- marginal benefit for vascular dementia [4]
Summary & Clinical practice guideline [3]
- statistically significant but clinically marginal improvement in measures of cognition & global assessment of dementia
- most studies were of short duration (6 months); this limits their ability to detect delay in onset or progression of dementia
Specific
donepezil clinical trials
References
- Kaduszkiewicz H et al
Cholinesterase inhibitors for patients with Alzheimer's
disease: Systematic review of randomised clinical trials.
BMJ 2005 Aug 6; 331:321-7.
PMID: 16081444
http://bmj.bmjjournals.com/cgi/content/full/331/7512/321
- Auchis AP et al,
Galantamine treatment of vascular dementia: A randomized trial.
Neurology 2007, 69:448
PMID: 17664404
- Raina P et al
Effectiveness of cholinesterase inhibitors and memantine for
treating dementia: evidence review for a clinical practice
guideline.
Ann Intern Med. 2008 Mar 4;148(5):379-97
PMID: 18316756
- Kavirajan H, Schneider LS
Efficacy and adverse effects of cholinesterase inhibitors
and memantine in vascular dementia: a meta-analysis of
randomised controlled trials.
Lancet Neurol. 2007 Sep;6(9):782-92
PMID: 17689146