Evidence map›Paper›PMID 16081444›Full record

SynthesisBMJ (Clinical research ed.)2005

Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials.

Hanna Kaduszkiewicz, Thomas Zimmermann, Hans-Peter Beck-Bornholdt, Hendrik van den Bussche

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 150 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
150citing papers in PubMed, 13 pooled it
26.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

150 citing papers in PubMed, 13 syntheses or guidelines pooled it, 514 citations in OpenAlex.

  1. Pooled it
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  5. A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2018
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Guideline
  9. Pooled it
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  14. NeuroEPO plus (NeuralCIMAlzheimer's research & therapy · 2023
    Trial
  15. Trial
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  18. Donepezil Plus Solifenacin (CPC-201) Treatment for Alzheimer's Disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2017
    Trial
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  20. Trial

90 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Hanna KaduszkiewiczDepartment of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. kaduszki@uke.uni-hamburg.de
Thomas Zimmermann
Hans-Peter Beck-Bornholdt
Hendrik van den Bussche
Universität Hamburg · DEUniversity Medical Center Hamburg-Eppendorf · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPharmacological treatment of Alzheimer's disease focuses on correcting the cholinergic deficiency in the central nervous system with cholinesterase inhibitors. Three cholinesterase inhibitors are currently recommended: donepezil, rivastigmine, and galantamine. This review assessed the scientific evidence for the recommendation of these agents. DATA SOURCES: The terms "donepezil", "rivastigmine", and "galantamine", limited by "randomized-controlled-trials" were searched in Medline (1989-November 2004), Embase (1989-November 2004), and the Cochrane Database of Systematic Reviews without restriction for language. STUDY SELECTION: All published, double blind, randomised controlled trials examining efficacy on the basis of clinical outcomes, in which treatment with donepezil, rivastigmine, or galantamine was compared with placebo in patients with Alzheimer's disease, were included. Each study was assessed independently, following a predefined checklist of criteria of methodological quality.

results22 trials met the inclusion criteria. Follow-up ranged from six weeks to three years. 12 of 14 studies measuring the cognitive outcome by means of the 70 point Alzheimer's disease assessment scale--cognitive subscale showed differences ranging from 1.5 points to 3.9 points in favour of the respective cholinesterase inhibitors. Benefits were also reported from all 12 trials that used the clinician's interview based impression of change scale with input from caregivers. Methodological assessment of all studies found considerable flaws--for example, multiple testing without correction for multiplicity or exclusion of patients after randomisation.

conclusionBecause of flawed methods and small clinical benefits, the scientific basis for recommendations of cholinesterase inhibitors for the treatment of Alzheimer's disease is questionable.

Indexed as

Alzheimer DiseaseCholinesterase InhibitorsDonepezilGalantamineHumansIndansPhenylcarbamatesPiperidinesRandomized Controlled Trials as TopicRivastigmineTreatment OutcomeCholinesterase InhibitorsDonepezilGalantamineIndansPhenylcarbamatesPiperidinesRivastigmine

Identifiers

PMID16081444
PMCPMC1183129
OpenAlexW2024214628

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.