ArticleAlzheimer's research & therapy2018
Comparative safety and effectiveness of cholinesterase inhibitors and memantine for Alzheimer's disease: a network meta-analysis of 41 randomized controlled trials.
Article in Alzheimer's research & therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
81 citing papers in PubMed, 6 syntheses or guidelines pooled it, 162 citations in OpenAlex.
- Antidementia drugs and nursing home placement: a systematic review and meta-analysis.European geriatric medicine · 2026Pooled it
- Bridging the gap: Efficacy of combined therapies for cognitive, behavioral, and functional outcomes in Alzheimer's disease - results from a systematic review and network meta-analysis.Journal of Alzheimer's disease : JAD · 2025Pooled it
- Rapid health technology assessment of galantamine for the treatment of Alzheimer's disease: A review.Medicine · 2025Pooled it
- Comparative efficacy and safety of symptomatic therapy and disease-modifying therapy for Alzheimer's disease: a systematic review and network meta-analysis.Frontiers in neuroscience · 2025Pooled it
- Pooled it
- Different Doses of Pharmacological Treatments for Mild to Moderate Alzheimer's Disease: A Bayesian Network Meta-Analysis.Frontiers in pharmacology · 2020Pooled it
- Bioavailability Study of a Transdermal Patch Formulation of Rivastigmine Compared with Exelon in Healthy Subjects.European journal of drug metabolism and pharmacokinetics · 2022Trial
- Memantine: updates from the past decade and implications for future novel therapeutic applications.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- Buwang Formula Regulates Microglial Metabolic Reprogramming and Modulates the mTOR/HIF-1α Pathway to Reduce Neuroinflammation in Diabetic Mice.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Why acetylcholinesterase inhibitors should be considered disease-modifying drugs for Alzheimer's disease?Aging clinical and experimental research · 2026Review
- Computational mechanistic insight of fungal metabolites for novel acetylcholinesterase inhibitors.Molecular diversity · 2026Article
- Long-Term Effect of Acetylcholinesterase Inhibitors on Behavioral and Psychological Symptoms of Dementia.International journal of geriatric psychiatry · 2026Article
- Dynamic associations of cholinesterase inhibitors and memantine with cognitive trajectories in individuals with Alzheimer's or mixed dementia: a real-world analysis using the quality registry SveDem.Alzheimer's research & therapy · 2025Observational
- Comparative safety of cholinesterase inhibitors and memantine for dementia: a protocol for a network meta-analysis of randomized controlled trials.Systematic reviews · 2025Article
- Gender Differences in the Effects of Exercise Interventions on Alzheimer's Disease.Brain sciences · 2025Review
- The Impact of Cognitive Impairment on Cardiovascular Disease.Journal of the American College of Cardiology · 2025Review
- Review
- Role of Saponins fromMolecules (Basel, Switzerland) · 2025Article
- DeepDrug as an expert guided and AI driven drug repurposing methodology for selecting the lead combination of drugs for Alzheimer's disease.Scientific reports · 2025Article
- 3-Hydroxytyrosol as a phenolic cholinesterase inhibitor with antiamnesic activity: a multimethodological study of selected plant phenolics.Frontiers in pharmacology · 2025Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCholinesterase inhibitors and memantine have been approved for management of Alzheimer's disease (AD), but there has been no consensus about the choice of various types and doses of drugs at different stages. Hence, we compared and ranked the efficacy and tolerability of these available drugs.
methodsWe searched PubMed, the Cochrane Central Register of Controlled Trials, and Embase for randomized controlled trials (RCTs) published from database inception to July 21, 2017. The primary outcomes were the mean overall changes in cognitive function and responders who had any adverse events. We conducted a random-effects network meta-analysis.
resultsForty-one RCTs were included in this study. Compared with placebo, galantamine 32 mg daily (standardized mean difference - 0.51, 95% credible interval - 0.67 to - 0.35), galantamine 24 mg daily (- 0.50, - 0.61 to - 0.40), and donepezil 10 mg daily (- 0.40, - 0.51 to - 0.29) were probably the most effective agents on cognition for mild to moderate AD, and memantine 20 mg combined with donepezil 10 mg (0.76, 0.39 to 1.11) was recommended for moderate to severe patients. Memantine showed the best profile of acceptability. Rivastigmine transdermal 15-cm
conclusionsPharmacological interventions have beneficial effects on cognition, function, and global changes, but not on neuropsychiatric symptoms, through current network meta-analysis. The choice of drugs may mainly depend on the disease severity and clinical symptoms.
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Registered trials
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.