Comparison Of Efficacy And Safety Between Donepezil And Multiple Drugs In The Treatment Of Alzheimer’s Disease Meta Analysis

Obiective: To compare donepezil with other cholinesterase inhibitors(galantamine,huperzine A,rivastigmine),NMDA receptor antagonists(Memantine),brain-stimulating drugs(piracetam),The efficacy and safety of calcium channel blockers(nanomembrane)and antioxidants(vitamin E)in the treatment of Alzheimer’s disease(AD).Methods: Computer search Pub Med,EMBase,Cochrane Library,Web of Science,MEDLINE,OVID,Wipnet,China Academic Journal Full-text Database(CNKI),China Biomedical Literature Database(CBM),Wanfang Database(Wan Fang Data)The search time limit was from 2001 to 2018,and the clinical research literature on randomized controlled treatment of Alzheimer’s disease with donepezil was included.Data extraction and quality evaluation were included in the literature,including the first author,publication time,drug,daily dose,gender,age,observation time,baseline simple mental state assessment scale(MMSE)score,and outcome index.The efficacy and safety of donepezil and various drugs in the treatment of Alzheimer’s disease were analyzed using Rev Man5.3 software.Results:1.There was no significant difference in the efficacy of MMSE scores between the donepezil 5mg group and the memantine group [MD=-0.27,95% CI(-1.04,0.50),Z=0.68,P=0.50].Adverse reactions occurred.There was no significant difference in the rate comparison [OR=1.66,95% CI(0.60,4.59),Z=0.98,P=0.33].2.The effect of MMSE score and CIBIC-plus score in patients treated with donepezil 10 mg was better than that of memantine group.The difference was statistically significant[MD=0.47,95% CI(0.19,0.74),Z=3.32,P=0.0009 <0.05;MD=0.17,95% CI(0.10,0.24),Z=4.88,P<0.00001];there was no significant difference in the total efficacy and adverse reaction rate between the donepezil 10 mg group and the memantine group [OR= 1.23,95%CI(0.63,2.39),Z=0.61,P=0.54;OR=1.12,95% CI(0.86,1.45),Z=0.85,P=0.39],treatment with donepezil 10 mg and memantine group There was no significant difference in the efficacy of post-ADL score,ADAS-cog score,and NPI score [MD=-0.28,95% CI(-0.66,0.10),Z=1.44,P=0.15;MD=-0.11,95 %CI(-1.07,0.85),Z = 0.23,P = 0.82;MD =-0.65,95% CI(-2.78,1.48),Z = 0.60,P = 0.55].3.There was no significant difference in the total efficacy and adverse reaction rate between the donepezil 10 mg group and the galantamine group [OR=1.57,95% CI(0.91,2.71),Z=1.61,P=0.10;OR= 0.70,95% CI(0.41,1.18),Z = 1.34,P = 0.18];there was no significant difference in the efficacy of MMSE score and NPI score between the donepezil 10 mg group and the galantamine group [MD=-0.29,95% CI(-1.00,0.42),Z=0.79,P=0.43;MD=-0.72,95% CI(-2.76,1.32),Z=0.69,P=0.49];patients in the galantamine group The therapeutic effect of ADL score and ADAS-cog score was better than that of donepezil 10 mg group.The difference was statistically significant [MD=0.54,95% CI(0.22,0.87),Z=3.26,P=0.001<0.05;MD=0.83,95% CI(0.22,1.44),Z = 2.66,P = 0.008.4.There was no significant difference in the total efficacy between the donepezil 5mg group and the Huperzine A group [OR=0.41,95% CI(0.09,1.85),Z=1.16,P=0.25].Comparison of MMSE scores There was no statistical difference [MD=-3.21,95% CI(-7.66,1.24),Z=1.41,P=0.16].5.The total efficacy of the donepezil 5mg group was better than that of the Nishen group.The incidence of adverse reactions was lower than that of the Nishen group.The difference was statistically significant [OR=5.63,95% CI(2.44,13.00),Z=4.05 P<0.0001;OR=0.20,95% CI(0.07,0.59),Z=2.92,P=0.003<0.05];the efficacy of MMSE score was better than that of the same membrane group,the difference was statistically significant [MD=6.69] 95%CI(4.44,8.93),Z=5.84,P<0.00001];the efficacy of ADL score was lower than that of the same group,the difference was statistically significant [MD=-2.40,95% CI(-4.19,-0.61),Z =2.62,P = 0.009 < 0.05].6.The total efficacy of the donepezil 5mg group was better than that of the piracetam group.The incidence of adverse reactions was lower than that of the piracetam group.The difference was statistically significant [OR=3.50,95% CI(1.53,8.01),Z =2.97,P=0.003<0.05;OR=0.21,95%CI(0.07,0.60),Z=2.92,P=0.004<0.05];the MMSE score was better than the piracetam group,the difference was statistically significant.Significance[MD=6.71,95% CI(2.52,10.90),Z=3.14,P=0.002<0.05];the efficacy of ADL score was better than that of piracetam group,the difference was statistically significant [MD=-2.54,95% CI(-3.44,-1.63),Z = 5.49,P < 0.00001].7.There was no significant difference in the efficacy of MMSE score,ADL score,ADAS-cog score and Blessed-Roth score between the donepezil 10 mg group and the rivastigmine group [MD=-0.19,95% CI(-0.62,0.24),Z = 0.86,P = 0.39;MD =-0.30,95%CI(-0.81,0.21),Z = 1.17,P = 0.24;MD =-0.03,95% CI(-1.88,1.83),Z =0.03,P=0.98;MD=-0.35,95% CI(-0.12,0.82),Z=1.46,P=0.14];the efficacy of the rivastigmine group GDS score was better than the donepezil 10 mg group,the difference was statistically significant.Significance [MD=0.19,95% CI(0.02,0.36),Z=2.18,P=0.03<0.05];there was no statistical difference in the incidence of adverse reactions after treatment with the donepezil10 mg group and the rivastigmine group [OR= 0.55,95% CI(0.27,1.13),Z = 1.63,P = 0.10].8.The effect of MMSE score in patients treated with donepezil 5 mg was better than that in vitamin E group.The difference was statistically significant [MD=3.03,95% CI(1.53,4.52),Z=3.97,P<0.0001].9.The effect of ADAS-cog score in patients treated with donepezil 10 mg was better than that in vitamin E group.The difference was statistically significant [MD=-5.37,95%CI(-9.53,-1.21),Z=2.53,P=0.01 <0.05].In conclusion:Donepezil is comparable to memantine,galantamine,and rivastigmine in total efficacy and adverse reactions.MMSE and CIBIC-plus are superior to memantine in terms of efficacy;galantamine is superior to donepezil in ADL and ADAS-cog;GDS The efficacy of rivastigmine is better than donepezil;donepezil is equivalent to huperzine A;donepezil is superior to nisin,piracetam and vitamin E,and the incidence of adverse reactions is lower than that of nisin and piracetam.