PMID- 25504005
OWN - NLM
STAT- MEDLINE
DCOM- 20160311
LR  - 20211124
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 32
IP  - 1
DP  - 2015 Jan
TI  - Peroxisome proliferator-activated receptor-gamma agonists for Alzheimer's disease 
      and amnestic mild cognitive impairment: a systematic review and meta-analysis.
PG  - 57-65
LID - 10.1007/s40266-014-0228-7 [doi]
AB  - BACKGROUND: Alzheimer's disease (AD) is the most common neurodegenerative disease 
      in the elderly, and close associations between AD and diabetes have been found. 
      Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists, as 
      newly-developed oral hypoglycaemic agents, were evaluated as a possible therapy 
      for AD. AIM: We systematically evaluated the efficacy and safety of PPAR-gamma 
      agonists in the treatment of AD and amnestic mild cognitive impairment (aMCI), 
      the prodromal stage of AD. METHODS: A search of the electronic databases PubMed, 
      EMBASE, CINAHL, Cochrane Library and China National Knowledge Infrastructure 
      (until July 2014) was conducted, and included randomized controlled trials. 
      Dichotomous data were expressed as risk ratios (RRs) with 95% confidence 
      intervals (CIs), and continuous data were expressed as mean differences (MD) with 
      95% CIs. The results were pooled using a random-effects model. RESULTS: Nine 
      eligible studies were identified, with 4,327 participants. Using the Alzheimer's 
      Disease Assessment Scale-Cognitive subscale, pioglitazone was found to be 
      efficacious, especially for patients with comorbid diabetes (MD -3.47, 95% CI 
      -4.40 to -2.54). Rosiglitazone was not efficacious, even for apolipoprotein E 
      (APOE) epsilon4 non-carriers (MD -0.31, 95% CI -1.12 to 0.51). There was no increase in 
      any adverse events (AEs) or serious AEs compared with placebo. Peripheral edema 
      was the most frequent AE related to PPAR-gamma agonist treatment (RR 4.14, 95% CI 
      2.37-7.23). CONCLUSIONS: There is insufficient evidence to support the use of 
      rosiglitazone in aMCI and AD patients in order to improve cognitive performance. 
      Nonetheless, the efficacy of pioglitazone seems to be promising, particularly for 
      patients with comorbid diabetes, however this needs to be further confirmed by 
      well-designed trials with large sample sizes. PPAR-gamma agonists such as 
      rosiglitazone and pioglitazone are generally well-tolerated in AD and aMCI 
      patients.
FAU - Liu, Jia
AU  - Liu J
AD  - Department of Neurology, Xuanwu Hospital, Capital Medical University, 45 
      Changchun Street, Beijing, 100053, China, Jason_liu1984@163.com.
FAU - Wang, Lu-ning
AU  - Wang LN
FAU - Jia, Jian-ping
AU  - Jia JP
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (PPAR gamma)
RN  - 0 (Thiazolidinediones)
RN  - 05V02F2KDG (Rosiglitazone)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Alzheimer Disease/*drug therapy
MH  - Cognitive Dysfunction/*drug therapy
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - PPAR gamma/*agonists
MH  - Pioglitazone
MH  - Randomized Controlled Trials as Topic
MH  - Rosiglitazone
MH  - Thiazolidinediones/therapeutic use
EDAT- 2014/12/17 06:00
MHDA- 2016/03/12 06:00
CRDT- 2014/12/16 06:00
PHST- 2014/12/16 06:00 [entrez]
PHST- 2014/12/17 06:00 [pubmed]
PHST- 2016/03/12 06:00 [medline]
AID - 10.1007/s40266-014-0228-7 [doi]
PST - ppublish
SO  - Drugs Aging. 2015 Jan;32(1):57-65. doi: 10.1007/s40266-014-0228-7.