Efficacy of memantine on behavioral and psychological symptoms related to dementia: A systematic meta-analysis
Efficacy of memantine on behavioral and psychological symptoms related to dementia: A systematic meta-analysis
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DOI：
10.1345/aph.1k372
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发表时间：
2008-01-01
影响因子：
2.9
通讯作者：
Katona, Cornelius L.
中科院分区：
文献类型：
--
作者：
Maidment, Ian D.;Fox, Chris G.;Katona, Cornelius L.
背景技术背景：与痴呆相关的行为和心理症状（BPSD）难以管理，并与不良患者结局相关。目的：系统分析美金刚治疗BPSD的资料。方法：我们检索了MEDLINE、EMBASE、Pharm-line、科克伦中心协作网、www.clinicaltrials.gov、www.controlled-trials.com和PsycINFO（1966- 2007年7月）。我们联系了制造商，并仔细检查了在我们搜索进一步参考文献时发现的文章的参考文献部分，包括会议记录。两名研究人员（IM和CF）独立审查了检索策略确定的所有研究。在我们的荟萃分析中，我们纳入了6项随机、平行组、双盲研究，这些研究采用神经精神量表（NPI）对BPSD进行评分。患者可能患有阿尔茨海默病，并接受美金刚治疗至少一个月。美金刚对NPI的总体疗效通过使用随机效应模型对研究间平均值之间的平均差异进行t检验来确定。结果：6项研究中有5项有NPI结局数据。在这5项研究中，868例患者接受美金刚治疗，882例患者接受安慰剂治疗。与安慰剂组相比，使用美金刚的患者在NPI量表上改善了1.99（95% CI -0.08至-3.91; p = 0.041）。结论：最初的数据似乎表明美金刚降低NPI评分，并可能在管理BPSD中发挥作用。然而，目前的数据存在许多局限性;效应量相对较小，美金刚是否产生显著的临床益处尚不清楚。
BACKGROUND: The behavioral and psychological symptoms related to dementia (BPSD) are difficult to manage and are associated with adverse patient outcomes. OBJECTIVE: To systematically analyze the data on memantine in the treatment of BPSD. METHODS: We searched MEDLINE, EMBASE, Pharm-line, the Cochrane Centre Collaboration, www.clinicaltrials.gov, www.controlled-trials.com, and PsycINFO (1966-July 2007). We contacted manufacturers and scrutinized the reference sections of articles identified in our search for further references, including conference proceedings. Two researchers (IM and CF) independently reviewed all studies identified by the search strategy. We included 6 randomized, parallel-group, double-blind studies that rated BPSD with the Neuropsychiatric Inventory (NPI) in our meta-analysis. Patients had probable Alzheimer's disease and received treatment with memantine for at least one month. Overall efficacy of memantine on the NPI was established with a t-test for the average difference between means across studies, using a random effects model. RESULTS: Five of the 6 studies identified had NPI outcome data. In these 5 studies, 868 patients were treated with memantine and 882 patients were treated with placebo. Patients on memantine improved by 1.99 on the NPI scale (95% CI -0.08 to -3.91; p = 0.041) compared with the placebo group. CONCLUSIONS: Initial data appear to indicate that memantine decreases NPI scores and may have a role in managing BPSD. However, there are a number of limitations with the current data; the effect size was relatively small, and whether memantine produces significant clinical benefit is not clear.