Review: Cholinesterase inhibitors do not reduce progression to dementia from mild cognitive impairment.

CONCLUSION In adults with mild cognitive impairment, cholinesterase inhibitors do not differ from placebo for progression to dementia at 1 and 3 years but increase nonserious adverse events.Cholinesterase inhibitors (ChEIs) vs placebo in adults with mild cognitive impairment*OutcomesNumber of trials (n)Weighted event ratesAt 16 wk to 3 yChEIsPlaceboRRR (95% CI)NNT (CI)Dementia at 1 y3 (2560)7.6%12%31% (0 to 53)NSDementia at 2 y2 (2048)12%18%33% (17 to 45)17 (12 to 34)Dementia at 3 y2 (1530)20%24%16% (-2 to 30)NSSerious adverse events6 (4207)19%19%3% (-10 to 14)NSRRI (CI)NNH (CI)Any adverse event6 (4207)89%82%9% (2 to 16)15 (10 to 50)Diarrhea7 (4761)29%18%110% (30 to 239)10 (7 to 15)Nausea7 (4761)22%9.1%197% (157 to 242)8 (5 to 34)Mortality7 (4719)3.3%3.3%8% (-46 to 21)NS*NS = not significant; other abbreviations defined in Glossary. Weighted event rates, RRR, RRI, NNT, NNH, and CI calculated from control event rates and risk ratios in article using a random-effects model.
PMID: 23420252 [PubMed - in process]

Source: Annals of Internal Medicine - February 19, 2013 Category: Internal Medicine Authors: Masoodi N Tags: Ann Intern Med Source Type: research