Comparison of the Efficacy and Side Effects of Treatment with Donepezil and Rivastigmine in the Treatment of Alzheimer's Disease by Means of Mata Analysis

• Main Authors: CHEN, WEI-JU, 陳薇如
• Other Authors: HUANG, CHIEN-TSAI
• Format: Others
• Language: zh-TW
• Published: 2017
• Online Access: http://ndltd.ncl.edu.tw/handle/e5mx5p

碩士 === 中臺科技大學 === 醫療暨健康產業管理系碩士班 === 105 === Research background: due to the improvement of medical standards, the average life expectancy of many people; aging is almost everyone can not avoid the fact. The current population aging is also a phenomenon of globalization, followed by the increase in chronic diseases. Drugs for cognitive deficits in the treatment of Alzheimer's disease include Donepezil, Rivastigmine, Galantamine, and the like (Reminyl®). There were 563,147 persons (18.45%) of the Mild cognitive impairment (MCI) in the elderly population aged over 65 in September 2016, and there were 243,430 people, accounting for 7.98 % (Including 98,747 persons with mild disability, accounting for 3.24%, and 144,683 or 4.74% of patients with mild orphrodisiac disorder). That is more than 65 years old for every 13 people that have a deaf who, while the elderly over the age of 80 every 5 people that there is a dementia, estimated in 2060 will increase the mentally handicapped population of 3.27 million people. At present, about 15 million people worldwide suffer from Alzheimer's disease, estimated to 2030, the number of patients will surge to 75 million people. Objective: To investigate the effects of these two drugs on the side effects of patients treated with Donepezil and Rivastigmine inorder to provide clinical reference before treatment. Methods: This study was used Evidence-based medicine. The literature search method, the use of online empirical medicine database The Cochrane Library, PubMed, Medline search, after the literature review, the appropriate screening of the literature to analyze the software RevMan5.3 to be analyzed and the results. This article is included in the elderly over 65 years of age (including 65 years old), and the use of Donepezil or Rivastigmine alone drugs, 30 weeks after taking the use of MMSE questionnaire for the elderly. Results: At the end of this study, a total of seven randomized controlled trials were included in the results of individual studies, and the side effects were analyzed for the use of the drug in the patient. Four clinical trials related to efficacy were identified in the literature as patient use Whether the slowness of the disease after the results (the other three do not meet the inclusion criteria). use Meta-analysis software RevMan5.3 software to obtain statistical results. The results of the side effects of the drug after the use of the drug were analyzed by a total of 940 samples from Donepezil, 433 studies of Rivastigmine, and whether the patient had slowed the disease after using the drug. Of the total of four literatures, Donepezil were included in 734 studies, Rivastigmine included a total of 466 studies. Using the statistical software to analyze the results of Rivastigmine and Donepezil, the results of the forest map are obtained (Figure 4.1.1). The results of the literature showed heterogeneity (p = 0.17), I2 = 40%, and the result of the fixed pattern was 0.32 (95% CI -0.43, -0.20). The results of the forest map showed that the diamond Does not cross invalid midline 1. The drug group was shown to be superior to Donepezil alone in the use of Rivastigmine. Side effects of the comparison, the two drugs are also different, the literature to find the side effects of patients with drugs Donepezil number 940 people have 297 people have side effects, Rivastigmine number of 433 people have 87 side effects, the results showed that P = 0.02, I2 = 62%, heterogeneity in heterogeneity test, so the random pattern was P = 0.79, I2 = 29%, and the result was (RD, 0.79; 95% CI, 0.41, 1.27). The final result of the forest map analysis showed that the mean value of Rivastigmine was greater than the standard deviation of Donepezil drug 0.03, and Rivastigmine had a significant effect on side effects in patients with Alzheimer's disease, so Donepezil side effects Less than Rivastigmine. The analysis showed that Donepezil 10mg NNT was 11, Rivastigmine 6mg NNT was 5; from high dose of NNT can be seen Rivastigmine 6mg for the treatment of Alzheimer's disease (Alzheimer's Disease) patients produced more than Donepezil 10mg; Rivastigmine 6mg for the treatment of Alzheimer's disease (Alzheimer's Disease) patients produced side effects than Donepezil 10mg. Conclusions: This study showed that Donepezil had lower efficacy than Rivastigmine and Rivastigmine than Donepezil in the treatment of Alzheimer's disease. This study suggests that patients with Alzheimer's disease can be treated with Rivastigmine in order to provide patients with more Good efficacy, due to the high side effects of Rivastigmine, please clinical staff for patients and patients with family members more health education.