How useful are cholinesterase inhibitors in the treatment of Alzheimer's disease? A number needed to treat analysis

✍ Scribed by Gill Livingston; Cornelius Katona

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 81 KB
• Volume: 15
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/(sici)1099-1166(200003)15:3<203::aid-gps100>3.0.co;2-9

✦ Synopsis

Objectives. To report on a Numbers Needed to Treat (NNT) analysis of the literature identi®ed through a systematic review of trials of cholinesterase inhibitors in Alzheimer's Disease.

Design. Search of Medline (1966±1998), EMBASE (1994±1999) and Psychlit (1974±1998) using the keywords cholinesterase and placebo dementia.

Settings. Double-blind, randomised, placebo-controlled trials. Subjects. People with Alzheimer's Disease. Interventions. Drug trials of acetylcholinesterase inhibitors (ChIs). Main outcome measures. Alzheimer's Disease Assessment Scale (Cognitive subscale), Clinician's Interview Based Impression of Change Plus, Mini Mental State Examination, Progressive Deterioration Scale.

Results. Small numbers of patients (in most cases between 3 and 7) need to be treated with appropriate dosages of ChIs to ameliorate the clinical symptoms, or postpone deterioration in one of them.

Conclusions. These small NNTs suggest that, despite their expense, the cholinesterase inhibitors have a valuable place in the current clinical management of AD.