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Latrepirdine for Alzheimer's disease
Sarah Chau1, Nathan Herrmann, Myuri T Ruthirakuhan
1Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room FG-05, Toronto, ON, Canada, M4N 3M5.
The Cochrane Database of Systematic Reviews
|April 22, 2015
Summary
Latrepirdine shows no significant effect on cognition or function in Alzheimer's disease (AD) patients. However, it may offer a modest benefit for behavioral symptoms, with comparable safety to placebo.
Area of Science:
- Neuroscience
- Pharmacology
- Gerontology
Background:
- Current Alzheimer's disease (AD) treatments offer limited symptomatic relief without disease modification.
- Latrepirdine modulates multiple AD-related targets, potentially offering symptomatic and disease-modifying effects.
- Previous randomized trials investigated latrepirdine's impact on cognition, function, and behavior in AD patients.
Purpose of the Study:
- To evaluate the efficacy and safety of latrepirdine for treating Alzheimer's disease.
- To synthesize evidence from randomized, double-blind, placebo-controlled trials on latrepirdine in AD.
- To assess latrepirdine's effects on cognitive, functional, and behavioral outcomes in AD patients.
Main Methods:
- Searched the Cochrane Dementia and Cognitive Improvement Group Specialized Register for latrepirdine (dimebon) trials.
- Included randomized, double-blind, placebo-controlled trials of latrepirdine in mild-to-severe AD.
- Extracted data, assessed study quality, and performed meta-analyses using intention-to-treat (ITT) principles.
Main Results:
- Six of seven trials (1697 participants) were included; five had high risk of bias.
- Low-quality evidence suggested a benefit on clinician-rated global impression (CIBIC-Plus).
- No significant effects were found on cognition (ADAS-Cog, MMSE) or function (ADCS-ADL) due to imprecision and low-quality evidence.
- High-quality evidence indicated a small benefit on neuropsychiatric symptoms (NPI).
- Latrepirdine demonstrated comparable safety and tolerability to placebo regarding adverse events and dropouts.
Conclusions:
- Meta-analysis limitations include small study numbers, imprecision, inconsistency, and bias.
- Latrepirdine is not associated with increased adverse events compared to placebo.
- Evidence suggests no effect on cognition or function in mild-to-moderate AD, but a modest behavioral benefit.
- Further research is warranted to explore latrepirdine's potential for neuropsychiatric symptoms in AD.
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