Huang, Yu-Yuan; Teng, Teng; D Giovane, Cinzia; Wang, Rong-Ze; Suckling, John; Shen, Xue-Ning; Chen, Shi-Dong; Huang, Shu-Yi; Kuo, Kevin; Cai, Wen-Jie; Chen, Ke-Liang; Feng, Lei; Zhang, Can; Liu, Cai-Yan; Li, Chun-Bo; Zhao, Qian-Hua; Dong, Qiang; Zhou, Xin-Yu; Yu, Jin-Tai (2023). Pharmacological treatment of neuropsychiatric symptoms of dementia: a network meta-analysis. Age and ageing, 52(6), afad091. Oxford University Press 10.1093/ageing/afad091
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BACKGROUND
Pharmacological treatments are very common to be used for alleviating neuropsychiatric symptoms (NPS) in dementia. However, decision on drug selection is still a matter of controversy.
AIMS
To summarise the comparative efficacy and acceptability of currently available monotherapy drug regimens for reducing NPS in dementia.
METHOD
We searched PubMed, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials between inception and 26 December 2022 without language restrictions; and reference lists scanned from selected studies and systematic reviews. Double-blind randomised controlled trials were identified from electronic databases for reporting NPS outcomes in people with dementia. Primary outcomes were efficacy and acceptability. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA).
RESULTS
We included 59 trials (15,781 participants; mean age, 76.6 years) and 15 different drugs in quantitative syntheses. Risperidone (standardised mean difference [SMD] -0.20, 95% credible interval [CrI] -0.40 to -0.10) and galantamine (-0.20, -0.39 to -0.02) were more effective than placebo in short-term treatment (median duration: 12 weeks). Galantamine (odds ratio [OR] 1.95, 95% CrI 1.38-2.94) and rivastigmine (1.87, 1.24-2.99) were associated with more dropouts than placebo, and some active drugs. Most of the results were rated as low or very low according to CINeMA.
CONCLUSIONS
Despite the scarcity of high-quality evidence, risperidone is probably the best pharmacological option to consider for alleviating NPS in people with dementia in short-term treatment when considering the risk-benefit profile of drugs.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) |
UniBE Contributor: |
Del Giovane, Cinzia |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
0002-0729 |
Publisher: |
Oxford University Press |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Jun 2023 15:31 |
Last Modified: |
18 Jul 2023 15:51 |
Publisher DOI: |
10.1093/ageing/afad091 |
PubMed ID: |
37381843 |
Uncontrolled Keywords: |
dementia network meta-analysis neuropsychiatric symptoms neuropsychiatry older people treatment |
BORIS DOI: |
10.48350/184239 |
URI: |
https://boris.unibe.ch/id/eprint/184239 |
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