Meta-analysis of efficacy of cholinesterase inhibitors on individual neuropsychiatric symptoms in Alzheimer’s disease, Parkinson’s disease and dementia with Lewy bodies

Lead Investigator: Iris Sommer, University Medical Center Groningen
Title of Proposal Research: Meta-analysis of efficacy of cholinesterase inhibitors on individual neuropsychiatric symptoms in Alzheimer’s disease, Parkinson’s disease and dementia with Lewy bodies
Vivli Data Request: 5924
Funding Source: Government Funding (ZonMw project number 636310010)
Potential Conflicts of Interest: None

Summary of the Proposed Research:

Alzheimer’s disease (AD) is the most prevalent type of dementia, affecting approximately 24 million people globally. It is estimated that Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) together affect an additional 10 million people globally (~1.5% of the elderly population).

Cognitive deficits, such as problems with memory, planning and reasoning, and neuropscyhiatric disturbances, such as depression and anxiety, are both important features of these diseases.

Cholinesterase inhibitors (ChEIs), such as donepezil and rivastigmine, form a type of drug that has a well established effect on the cognitive deficits. However, the beneficial effect on neuropsychiatric disturbances is much less clear. A possible explanation for the inconsistent results of ChEIs on neuropsychiatric disturbances is that the definition of ‘neuropsychiatric’ is too broad, as it includes symptoms such as hallucinations and delusions, but also depression, anxiety and irritability, among others.

Therefore, we want to conduct a meta-analysis on the efficacy of ChEIs on all individual items of neuropsychiatric outcome measures, to assess which subdomains benefit from treatment and which do not. Individual trials are usually not powered for this subanalysis, which is why we want to pool all the available data.

We believe that this meta-analysis will form the basis for a more targeted approach for treating neuropsychiatric symptoms in PD, AD and DLB.

Requested Studies:

A 24-week, Double-blind, Double-dummy, Randomized, Parallel-group Study to Investigate the Effects of Rosiglitazone (Extended Release Tablets), Donepezil, and Placebo as Monotherapy on Cognition and Overall Clinical Response in APOE ε4-stratified Subjects With Mild to Moderate Alzheimer’s Disease. (REFLECT-1)
Sponsor: GlaxoSmithKline
Study ID: NCT00428090
Sponsor ID: 105640

Efficacy and Safety Study for Subjects With Mild-to-Moderate Alzheimer’s Disease
Data Contributor: AbbVie
Sponsor ID: M10-984

Evaluate the Efficacy and Safety of ABT-126 in Subjects With Mild to Moderate Alzheimer’s Disease
Data Contributor: AbbVie
Sponsor ID: M10-985

Efficacy and Safety Study of ABT-288 in Subjects With Mild-to-Moderate Alzheimer’s Disease
Data Contributor: AbbVie
Sponsor ID: M10-822

Galantamine in the Treatment of Alzheimer’s Disease: Flexible Dose Range Trial
Sponsor: Johnson & Johnson
Study ID: NCT00253227
Sponsor ID: CR006028

Placebo-Controlled Evaluation of Galantamine in the Treatment of Alzheimer’s Disease: Safety and Efficacy of a Controlled-Release Formulation
Sponsor: Johnson & Johnson
Study ID: NCT00253214
Sponsor ID: CR006037

Placebo-controlled evaluation of galantamine in the treatment of Alzheimer’s disease: Evaluation of safety and efficacy under a slow titration regimen
Sponsor: Johnson & Johnson
Study ID: GAL-USA-10
Sponsor ID: GAL-USA-10