JNNP: Systematic review and metaanalysis of anti-A beta drug therapy for mild to moderate Alzheimer's disease.

Alzheimer's disease (AD) occurs decades before clinical symptoms occur, accompanied by the deposition of amyloid β (A beta) peptide plaques, which accumulate in the cortical layer and hippocupial body.
or reverse pathophysiological processes at an early stage is the preferred strategy for later stages.
the past 20 years, efforts have been made to develop A-beta-targeted agents as potential disease relief therapies (DMTs) for mild to moderate ADs.
study aims to study the efficacy and safety of A-beta-targeted drug therapy for mild and moderate Alzheimer's disease.
methods: MEDLINE, Embase, Cochrane Control Trial Centre Registry, PsycINFO, WHO's International Clinical Trials Registration Platform Search Portal have been searched since its instation until April 2020.
we used a random effect meta-analysis to produce a set estimate.
two judges (XZ and YG) independently filter the titles and summaries of eligible full-text studies and use predefined extract tables to extract data from eligible studies.
The information gathered from the included studies includes research characteristics (e.g., author name, year of publication, study design and sample size); and AD levels; intervention characteristics (e.g., treatment style, drug type, dose, and duration of study treatment), comparative characteristics (e.g., control type, treatment dose and duration), and results (e.g. ADAS Cog, ADCS-ADL, MMSE, CDR-SOB, and follow-up time).
we collected the results of the longest follow-up time for trials with multiple follow-up points, data, or reports.
sequence analysis (TSA) was performed to avoid random errors due to sparse data and repeated testing of accumulated data.
results: 19 randomized controlled trials, 17 of which had a lower risk of bias, including 12 903 participants.
meta-analysis showed no difference between anti-A beta drugs and placebos on the Cognitive Subtesta (ADAS Cog) of the Alzheimer's Assessment Scale (ADAS Cog) (Average Difference (MD): 0. 20,95% CI-0.40-0.81; I2-99.8%; Minimum significant difference 3.1-3.8 points, moderate determinative evidence).
for ADAS Cog, the results suggest that a drug that increases the rate of A-beta removal may have different effects than a drug that reduces A-beta-produced (MD: 0.78, 95% CI-0.99 to .92) (MD: 0.78, 95% CI-0.99 to .92) MD: 0.78, 95% CI 0.25-1.32) (interaction p.lt;0.000001);
the placebo group, the adverse events associated with anti-A beta drugs were anxiety, depression, diarrhea, fatigue, rash, fainting and vomiting.
current evidence, anti-A beta interventions are unlikely to have a significant impact on slowing cognitive or functional decline.
the subgroup analysis showed that A-beta removal drugs may have benefits, the credibility of the analysis was limited.
Lu L, Zheng X, Wang S, et al Anti-A beta agents for mild to moderate Alzheimer's disease: system review and meta-analysisjournal of Neurology, Neurosurgery and Psypsy Published Online First: 12 October 2020. doi: 10.1136/jnnp-2020-3234 97MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
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