Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#humans #alzheimer-disease #atorvastatin #donepezil #galantamine

Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis

Deng et al., 2024 | Medicine (Baltimore) | Systematic Review

Citation

Deng Xiaoyan, Li Daishun. Effect of long-term pharmacological treatments on Alzheimer disease: A systematic review and network meta-analysis. Medicine (Baltimore). 2024-Sep-20;103(38):e39753. doi:10.1097/MD.0000000000039753

Abstract

BACKGROUND: To analyze and compare the pharmacological treatments for Alzheimer disease (AD), we will conduct a systematic review and network meta-analysis focusing on their efficacy and safety over a duration exceeding 1 year. METHODS: We searched the databases of PubMed, Scopus, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and CNKI until July 30, 2023, for randomized controlled trials (RCTs) evaluating pharmacological treatments for AD. RESULTS: Seventeen RCTs, comprising 7214 participants, investigated the efficacy of the following drugs: Donepezil, Rivastigmine, Galantamine, Memantine, Ginkgo biloba extract (EGb), Atorvastatin-calcium and Vitamin B in the treatment of AD. The network meta-analysis resulted indicated that placebo demonstrated greater effectiveness compared to Atorvastatin-calcium 80 mg (mean different [MD] = -6.93, confidence interval [CI] -11.57, -2.29) and Rivastigmine 12 mg (MD = -3.33, CI -6.56, -0.09). EGb120 mg exhibited a greater improvement in cognition compared to Atorvastatin-calcium 80 mg (MD = 7.77, CI 2.07, 13.46) and Rivastigmine 12 mg + EGb120 mg (MD = 9.92, CI 1.32, 17.22). EGb 120 mg emerged as the most efficient intervention for cognition, while placebo demonstrated the least harm over a period exceeding 1 year. CONCLUSIONS: In this network meta-analysis of studies of patients with AD and a follow-up period of at least 1 year, EGb 120 mg demonstrated cognitive benefits, while placebo posed the least harm for AD. More RCTs are required to address the uncertainty surrounding the efficacy of medication.

Key Findings

Seventeen RCTs, comprising 7214 participants, investigated the efficacy of the following drugs: Donepezil, Rivastigmine, Galantamine, Memantine, Ginkgo biloba extract (EGb), Atorvastatin-calcium and Vitamin B in the treatment of AD. The network meta-analysis resulted indicated that placebo demonstrated greater effectiveness compared to Atorvastatin-calcium 80 mg (mean different [MD] = -6.93, confidence interval [CI] -11.57, -2.29) and Rivastigmine 12 mg (MD = -3.33, CI -6.56, -0.09). EGb120 mg e

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population ad and a follow
Sample Size 7214
Age Range See abstract
Condition cognitive

MeSH Terms

  • Humans
  • Alzheimer Disease
  • Atorvastatin
  • Donepezil
  • Galantamine
  • Ginkgo biloba
  • Ginkgo Extract
  • Memantine
  • Plant Extracts
  • Randomized Controlled Trials as Topic
  • Rivastigmine
  • Treatment Outcome

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09