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Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis

BACKGROUND: This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychologic...

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Autores principales: Chen, Ruey, Chan, Pi-Tuan, Chu, Hsin, Lin, Yu-Cih, Chang, Pi-Chen, Chen, Chien-Yu, Chou, Kuei-Ru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565113/
https://www.ncbi.nlm.nih.gov/pubmed/28827830
http://dx.doi.org/10.1371/journal.pone.0183586
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author Chen, Ruey
Chan, Pi-Tuan
Chu, Hsin
Lin, Yu-Cih
Chang, Pi-Chen
Chen, Chien-Yu
Chou, Kuei-Ru
author_facet Chen, Ruey
Chan, Pi-Tuan
Chu, Hsin
Lin, Yu-Cih
Chang, Pi-Chen
Chen, Chien-Yu
Chou, Kuei-Ru
author_sort Chen, Ruey
collection PubMed
description BACKGROUND: This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions. METHODS: PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments. RESULTS: Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p < .001), BPSD (g = −0.878, p < .001) and global functions (g = −0.585, p = .004). Gradual titration of memantine plus a fixed dose and gradual titration of donepezil as well as a fixed dose and gradual titration of memantine resulted in limited improvements in cognitive functions(g = 0.371, p = .005), BPSD(g = −0.913, p = .001), and global functions(g = −0.371, p = .001). CONCLUSION: Both in the 24th week and at the final evaluation point, the combination of donepezil and memantine led to greater improvement in cognitive functions, BPSD, and global functions than did donepezil alone in patients with moderate to severe Alzheimer Disease.
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spelling pubmed-55651132017-08-28 Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis Chen, Ruey Chan, Pi-Tuan Chu, Hsin Lin, Yu-Cih Chang, Pi-Chen Chen, Chien-Yu Chou, Kuei-Ru PLoS One Research Article BACKGROUND: This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global functions. METHODS: PubMed, Medline, Embase, PsycINFO, and Cochrane databases were used to search for English and non-English articles for inclusion in the meta-analysis to evaluate the effect size and incidence of adverse drug reactions of different treatments. RESULTS: Compared with patients who received donepezil alone, those who received donepezil in combination with memantine exhibited limited improvements in cognitive functions (g = 0.378, p < .001), BPSD (g = −0.878, p < .001) and global functions (g = −0.585, p = .004). Gradual titration of memantine plus a fixed dose and gradual titration of donepezil as well as a fixed dose and gradual titration of memantine resulted in limited improvements in cognitive functions(g = 0.371, p = .005), BPSD(g = −0.913, p = .001), and global functions(g = −0.371, p = .001). CONCLUSION: Both in the 24th week and at the final evaluation point, the combination of donepezil and memantine led to greater improvement in cognitive functions, BPSD, and global functions than did donepezil alone in patients with moderate to severe Alzheimer Disease. Public Library of Science 2017-08-21 /pmc/articles/PMC5565113/ /pubmed/28827830 http://dx.doi.org/10.1371/journal.pone.0183586 Text en © 2017 Chen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chen, Ruey
Chan, Pi-Tuan
Chu, Hsin
Lin, Yu-Cih
Chang, Pi-Chen
Chen, Chien-Yu
Chou, Kuei-Ru
Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title_full Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title_fullStr Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title_full_unstemmed Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title_short Treatment effects between monotherapy of donepezil versus combination with memantine for Alzheimer disease: A meta-analysis
title_sort treatment effects between monotherapy of donepezil versus combination with memantine for alzheimer disease: a meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565113/
https://www.ncbi.nlm.nih.gov/pubmed/28827830
http://dx.doi.org/10.1371/journal.pone.0183586
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