Pharmacological treatment of neuropsychiatric symptoms of dementia: a network meta-analysis

作者全名："Huang, Yu-Yuan; Teng, Teng; Giovane, Cinzia D.; 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"

作者地址："[Huang, Yu-Yuan; Wang, Rong-Ze; Shen, Xue-Ning; Chen, Shi-Dong; Huang, Shu-Yi; Kuo, Kevin; Cai, Wen-Jie; Chen, Ke-Liang; Zhao, Qian-Hua; Dong, Qiang; Yu, Jin-Tai] Fudan Univ, Natl Ctr Neurol Disorders, Dept Neurol, Shanghai, Peoples R China; [Huang, Yu-Yuan; Wang, Rong-Ze; Shen, Xue-Ning; Chen, Shi-Dong; Huang, Shu-Yi; Kuo, Kevin; Cai, Wen-Jie; Chen, Ke-Liang; Zhao, Qian-Hua; Dong, Qiang; Yu, Jin-Tai] Fudan Univ, Huashan Hosp, Inst Neurol, Natl Ctr Neurol Disorders,State Key Lab Med Neurob, Shanghai, Peoples R China; [Huang, Yu-Yuan; Wang, Rong-Ze; Shen, Xue-Ning; Chen, Shi-Dong; Huang, Shu-Yi; Kuo, Kevin; Cai, Wen-Jie; Chen, Ke-Liang; Zhao, Qian-Hua; Dong, Qiang; Yu, Jin-Tai] Fudan Univ, Shanghai Med Coll, MOE Frontiers Ctr Brain Sci, Natl Ctr Neurol Disorders, Shanghai, Peoples R China; [Teng, Teng; Zhou, Xin-Yu] Chongqing Med Univ, Affiliated Hosp 1, Dept Psychiat, Chongqing, Peoples R China; [Giovane, Cinzia D.] Univ Bern, Inst Primary Hlth Care, Bern, Switzerland; [Suckling, John] Univ Cambridge, Med Res Council, Dept Psychiat, Cambridge, England; [Suckling, John] Univ Cambridge, Wellcome Trust Behav & Clin Neurosci Inst, Cambridge, England; [Feng, Lei] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Psychol Med, Singapore, Singapore; [Zhang, Can] Massachusetts Gen Hosp, Dept Neurol, Charlestown, MA USA; [Zhang, Can] Harvard Med Sch, Charlestown, MA USA; [Liu, Cai-Yan] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Neurol, Beijing, Peoples R China; [Li, Chun-Bo] Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Shanghai, Peoples R China; [Yu, Jin-Tai] Fudan Univ, Huashan Hosp, Shanghai Med Coll, Dept Neurol, 12th Wulumuqi Zhong Rd, Shanghai 200040, Peoples R China; [Yu, Jin-Tai] Fudan Univ, Huashan Hosp, Inst Neurol, Shanghai Med Coll, 12th Wulumuqi Zhong Rd, Shanghai 200040, Peoples R China"

通信作者："Zhou, XY (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Psychiat, Chongqing, Peoples R China.; Yu, JT (通讯作者)，Fudan Univ, Huashan Hosp, Shanghai Med Coll, Dept Neurol, 12th Wulumuqi Zhong Rd, Shanghai 200040, Peoples R China.; Yu, JT (通讯作者)，Fudan Univ, Huashan Hosp, Inst Neurol, Shanghai Med Coll, 12th Wulumuqi Zhong Rd, Shanghai 200040, Peoples R China."

来源：AGE AND AGEING

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001024625600001

JCR分区：Q1

影响因子：6

年份：2023

卷号：52

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：dementia; neuropsychiatric symptoms; treatment; neuropsychiatry; network meta-analysis; older people

摘要："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."

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