Evidence map›Paper›PMID 41188985›Full record

ArticleSystematic reviews2025

Comparative safety of cholinesterase inhibitors and memantine for dementia: a protocol for a network meta-analysis of randomized controlled trials.

Moaz Elsayed Abouelmagd, Nereen A Almosilhy, Hamdy A Makhlouf, Amr K Hassan, Ahmed S A Osman, Mahmoud Diaa Hindawi, Ahmed Elshahat, Asmaa Zakria Alnajjar, Mohamed M M Mustafa, Omar Khaled Abdelsalam and 4 more

Abstract read
In one paragraph

Article in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

14 authors.

Moaz Elsayed AbouelmagdKasr-Alainy Faculty of Medicine, Cairo University, Cairo, Egypt. moaz.s.sayed@gmail.com.ORCID 0000-0002-0511-2429
Nereen A AlmosilhyDepartment of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt.ORCID 0000-0003-2437-7059
Hamdy A MakhloufFaculty of Medicine, Minia University, Minia, Egypt.ORCID 0009-0008-0907-4475
Amr K HassanSchool of Medicine, University of California, Irvine, CA, USA.ORCID 0000-0002-8281-9268
Ahmed S A OsmanFaculty of Medicine, Minia University, Minia, Egypt.ORCID 0009-0002-2871-9925
Mahmoud Diaa HindawiFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0009-0001-3085-6665
Ahmed ElshahatFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0009-0009-0042-6101
Asmaa Zakria AlnajjarFaculty of Medicine, Al-Azhar University, Gaza, Palestine.ORCID 0000-0002-1254-4289
Mohamed M M MustafaFaculty of Pharmacy, Egyptian Russian University, Badr City, Egypt.ORCID 0009-0002-8987-1875
Omar Khaled AbdelsalamFaculty of Medicine, New Mansoura University, New Mansoura, Egypt.ORCID 0009-0005-1609-1036
Abdelrahman MadyFaculty of Medicine, Al-Azhar University, Cairo, Egypt.ORCID 0000-0002-3816-4727
Ahmed ShaheenAlexandria Faculty of Medicine, Alexandria, Egypt.ORCID 0000-0001-9731-5065
Matthew J BarrettDepartment of Neurology, Virginia Commonwealth University, Richmond, VA, USA.
Ahmed NegidaDepartment of Neurology, Virginia Commonwealth University, Richmond, VA, USA.ORCID 0000-0001-5363-6369

Funding

Elucidating the Role of Cholinergic Degeneration in Cognitive Fluctuations in Lewy Body DementiaR01NS142622 · NINDS · VIRGINIA COMMONWEALTH UNIVERSITY · PI Matthew James Barrett · 2025 to 2026
$1.4M
NINDS NIH HHS R01 NS142622
6 · The paper itself

Abstract

backgroundDementia is a growing public health concern, affecting over 55 million people worldwide, with Alzheimer's disease (AD) being the most prevalent cause. Cholinesterase inhibitors (ChEIs) and memantine remain the mainstay pharmacological treatment for AD and other dementias, despite their modest benefits and potential adverse effects. The safety profiles of these medications, particularly at different doses and formulations, remain inadequately explored, necessitating a comprehensive evaluation.

methodsThis systematic review and network meta-analysis (NMA) will assess the safety of ChEIs (donepezil, galantamine, rivastigmine) and memantine in dementia treatment. We will include randomized controlled trials (RCTs) with ≥ 3 months of follow-up, evaluating adverse events (AEs), serious adverse events (SAEs), and treatment discontinuation rates. A comprehensive literature search will be conducted in PubMed, Scopus, Web of Science, and Cochrane Library, with additional searches in Google Scholar and reference lists of included studies. Data extraction will follow a standardized approach, and study quality will be assessed using the Cochrane risk-of-bias tool-2. A Frequentist or Bayesian NMA framework will be used to compare safety profiles, with heterogeneity assessed using the I DISCUSSION: By addressing gaps in prior NMAs, this study aims to provide an in-depth evaluation of safety outcomes associated with different ChEI and memantine doses and formulations across various dementia types. The findings will support clinicians in making informed treatment decisions and guide future research and policy development for dementia management. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42025642902).

Indexed as

Cholinesterase InhibitorsDementiaMemantineAlzheimer DiseaseHumansMeta-Analysis as TopicNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicSystematic Reviews as TopicCholinesterase InhibitorsMemantineAdverse eventsCholinesterase inhibitorsDementiaMemantineNetwork meta-analysisProtocol

Identifiers

PMID41188985
PMCPMC12584256

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.