Evidence map›Paper›PMID 26680338›Full record

SynthesisInternational journal of geriatric psychiatry2016

The comparative efficacy and safety of cholinesterase inhibitors in patients with mild-to-moderate Alzheimer's disease: a Bayesian network meta-analysis.

Hisanori Kobayashi, Takashi Ohnishi, Ryoko Nakagawa, Kazutake Yoshizawa

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

Synthesis in International journal of geriatric psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 10 pooled it
5.3field-weighted citation impact, top 5% 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

37 citing papers in PubMed, 10 syntheses or guidelines pooled it, 77 citations in OpenAlex.

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  5. Apathy Associated with Alzheimer's Disease.Current Alzheimer research · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Hisanori KobayashiEvidence Generation Department, Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
Takashi OhnishiEvidence Generation Department, Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
Ryoko NakagawaEvidence Generation Department, Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
Kazutake YoshizawaEvidence Generation Department, Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
Janssen (Belgium) · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComparative evidence for efficacy and safety of second-generation cholinesterase inhibitors (ChEIs) is still sparse.

objectivesThe purpose of this research is to compare three ChEIs, donepezil, galantamine and rivastigmine, in patients with mild-to-moderate Alzheimer's disease (AD).

methodsWe conducted a systematic review for published articles and included randomised, double-blind, placebo-controlled trials and head-to-head randomised trials evaluating the efficacy and safety of ChEIs in patients with AD. We examined Alzheimer's Disease Assessment Scale, cognitive subscale (ADAS-Cog), Neuropsychiatric Inventory (NPI), Clinician's Interview-Based Impression of Change plus caregiver's input (CIBIC+) and Clinical Global Impression of Change (CGIC) as efficacy endpoints. Withdrawals due to adverse events and number of patients experiencing nausea, vomiting, diarrhoea and dizziness were examined as safety profiles. Network meta-analyses were sequentially performed for efficacy and safety outcomes based on drug/dose treatment conditions.

resultsAmong the 21 trials included, network meta-analysis showed that all treatments were significantly more efficacious than placebo in cognition measured by ADAS-Cog. All treatments except galantamine were significantly more efficacious than placebo in global change in CIBIC+ or CGIC. Across all conditions, no significant efficacy was observed in neuropsychiatric symptoms measured by NPI. Derived hierarchies in the efficacy of treatment conditions were variables across efficacy and safety.

conclusionsOur analysis is the first attempt to incorporate available direct and indirect evidence. The results suggest that ChEIs should have significant efficacy for cognition and global change assessment, but the efficacy on neuropsychiatric symptoms is questionable in patients with mild-to-moderate AD.

Indexed as

Alzheimer DiseaseCholinesterase InhibitorsCognitionAgedBayes TheoremDonepezilFemaleGalantamineHumansIndansMaleMiddle AgedPiperidinesRandomized Controlled Trials as TopicRivastigmineCholinesterase InhibitorsDonepezilGalantamineIndansPiperidinesRivastigmineAlzheimer's diseasecholinesterase inhibitorsmeta-analysis

Identifiers

PMID26680338
PMCPMC6084309
OpenAlexW2197001618

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.