Evidence map›Paper›PMID 39935003›Full record

ArticleClinical pharmacology and therapeutics2025

Population-Based Validation Results From the Drug Repurposing for Effective Alzheimer's Medicines (DREAM) Study.

Rishi J Desai, Vijay R Varma, Mufaddal Mahesri, Su Been Lee, Ariel Freedman, Tobias Gerhard, Jodi Segal, Seanna Vine, Mary Beth E Ritchey, Daniel B Horton and 1 more

Abstract readValidation Study
In one paragraph

Article in Clinical pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
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

11 authors.

Rishi J DesaiDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0003-0299-7273
Vijay R VarmaClinical & Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland, USA.
Mufaddal MahesriDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-6684-2337
Su Been LeeDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Ariel FreedmanDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Tobias GerhardCenter for Pharmacoepidemiology and Treatment Science, Institute for Health, Healthcare Policy and Aging Research, Ernest Mario School of Pharmacy, Rutgers University, New Brunswick, New Jersey, USA.
Jodi SegalDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Seanna VineDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
Mary Beth E RitcheyCenter for Pharmacoepidemiology and Treatment Science, Institute for Health, Healthcare Policy and Aging Research, Ernest Mario School of Pharmacy, Rutgers University, New Brunswick, New Jersey, USA.
Daniel B HortonCenter for Pharmacoepidemiology and Treatment Science, Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA.ORCID 0000-0002-1831-1339
Madhav ThambisettyClinical & Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland, USA.

Funding

New Jersey Alliance for Clinical Translational Science: NJ ACTSUL1TR003017 · NCATS · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI PANETTIERI, REYNOLD ALEXANDER · 2019 to 2023
$28.9M
NJ ACTS: A Platform for Translational Science in New JerseyUM1TR004789 · NCATS · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Reynold Alexander Panettieri · 2024 to 2026
$16.8M
Safety of Drugs Commonly Used Off-Label in Children Despite Insufficient Evidence of Efficacy and SafetyR01HD109335 · NICHD · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Daniel Benjamin Horton · 2022 to 2026
$3.3M
Antibiotics, Juvenile Idiopathic Arthritis, and Antirheumatic Treatment ResponseR01AR074436 · NIAMS · RUTGERS, THE STATE UNIV OF N.J. · PI HORTON, DANIEL BENJAMIN · 2019 to 2022
$2.1M
NCATS NIH HHS UL1 TR003017NCATS NIH HHS UM1 TR004789NIAMS NIH HHS R01 AR074436NIA NIH HHSNICHD NIH HHS R01 HD109335
6 · The paper itself

Abstract

We evaluated whether drugs approved for other indications that also target metabolic drivers of Alzheimer's disease and related dementia (ADRD) pathogenesis are associated with delayed onset of ADRD. Using routinely collected healthcare data from two population-based data sources from the US (Medicare) and UK (CPRD), we conducted active comparator, new-user cohort studies. Four alternate analytic and design specifications were implemented: (1) an as-treated follow-up approach, (2) an as-started follow-up approach incorporating a 6-month induction period, (3) incorporating a 6-month symptom to diagnosis period to account for misclassification of ADRD onset, and (4) identifying ADRD through symptomatic prescriptions and diagnosis codes. Of the 10 drug pairs evaluated, hydrochlorothiazide vs. dihydropyridine CCBs showed meaningful reductions in 3 out of 4 analyses that addressed specific biases including informative censoring, reverse causality, and outcome misclassification (pooled hazard ratios [95% confidence intervals] across Medicare and CPRD: 0.81 [0.75-0.88] in Analysis 1, 0.98 [0.92-1.06] in Analysis 2, 0.83 [0.75-0.91] in Analysis 3, 0.75 [0.65-0.85] in Analysis 4). Amiloride vs. triamterene, although less precise, also suggested a potential reduction in risk in 3 out of 4 analyses (0.86 [0.66-1.11] in Analysis 1, 0.98 [0.79-1.23] in Analysis 2, 0.74 [0.54-1.00] in Analysis 3, 0.61 [0.36-1.05] in Analysis 4). Other analyses suggested likely no major differences in risk (probenecid, salbutamol, montelukast, propranolol/carvedilol, and anastrozole) or had limited precision precluding a definitive conclusion (semaglutide, ciloztozol, levetiracetam). Future replication studies should be considered to validate our findings.

Indexed as

Alzheimer DiseaseDrug RepositioningAgedAged, 80 and overCohort StudiesFemaleHumansHydrochlorothiazideMaleMedicareUnited KingdomUnited StatesHydrochlorothiazide

Identifiers

PMID39935003
PMCPMC13127832

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Registered trials

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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.