Safety and efficacy of acetylcholinesterase inhibitors for Alzheimer’s disease: A systematic review and meta-analysis

Gao, Yaqi; Liu, Yulin; Li, Yanfang

doi:10.17219/acem/176051

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2024

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Cited by 2 publications

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The Use of Natural Products for Preventing Cognitive Decline/Providing Neuroprotection

Tabatabaei-Malazy,

Azizi,

Abdollahi

2024

Handbook of Experimental Pharmacology

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The Use of Natural Products for Preventing Cognitive Decline/Providing Neuroprotection

Tabatabaei-Malazy,

Azizi,

Abdollahi

2024

Handbook of Experimental Pharmacology

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Association between Polypharmacy and Adverse Events in Patients with Alzheimer’s Disease: An Analysis of the Japanese Adverse Drug Event Report Database (JADER)

Otani,

Kanda,

Ngatu

et al. 2024

Medicina

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Background and Objectives: Alzheimer’s disease is a global health concern, with a rising prevalence among the elderly. Current pharmacological treatments, including acetylcholinesterase inhibitors (AChEIs) and N-Methyl D-Aspartate (NMDA) receptor antagonists, are associated with adverse events (AEs), particularly in the context of polypharmacy. This study aimed to investigate the relationship between Alzheimer’s disease treatment combinations, the number of concomitant medications, and the occurrence of AEs. Materials and Methods: Data from the Japanese Adverse Drug Event Report database, spanning from April 2004 to June 2020, were analyzed. Patients aged 60 and older with Alzheimer’s disease treated with AChEIs (donepezil, galantamine, and rivastigmine) or the NMDA receptor antagonist memantine were included. Logistic regression models were employed to assess the association between AEs and Alzheimer’s disease drug combinations, as well as the number of concomitant medications. Results: Among 2653 patients, 47.7% were prescribed five or more drugs. The frequency of AEs was 6.4% for bradycardia, 4.6% for pneumonia, 3.6% for altered state of consciousness, 3.5% for seizures, 3.5% for decreased appetite, 3.5% for vomiting, 3.4% for loss of consciousness, 3.4% for fracture, 3.2% for cardiac failure, and 3.0% for falls. The combination of memantine with AChEIs was associated with a higher risk of bradycardia, whereas donepezil alone was linked to a reduced risk of fractures and falls. Polypharmacy was significantly correlated with an increased incidence of AEs, particularly altered state of consciousness, decreased appetite, vomiting, and falls. The adjusted odds ratios for using five or more drugs compared to no drugs was 10.45 for altered state of consciousness, 7.92 for decreased appetite, 4.74 for vomiting, and 5.95 for falls. Conclusions: In the treatment of Alzheimer’s disease, the occurrence of AEs is associated with the number of concurrent medications, independently of the known AEs of Alzheimer’s disease drugs and their combination patterns.

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Safety and efficacy of acetylcholinesterase inhibitors for Alzheimer’s disease: A systematic review and meta-analysis

Abstract: Gao Y, Liu Y, Li Y. The safety and efficacy of acetylcholinesterase inhibitors for Alzheimer's disease: A systematic review and meta-analysis [published online as ahead of print on March 1, 2024].

Cited by 2 publications

References 72 publications

The Use of Natural Products for Preventing Cognitive Decline/Providing Neuroprotection

The Use of Natural Products for Preventing Cognitive Decline/Providing Neuroprotection

Association between Polypharmacy and Adverse Events in Patients with Alzheimer’s Disease: An Analysis of the Japanese Adverse Drug Event Report Database (JADER)

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