PMID- 32495063
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240413
IS  - 2193-8253 (Print)
IS  - 2193-6536 (Electronic)
IS  - 2193-6536 (Linking)
VI  - 9
IP  - 2
DP  - 2020 Dec
TI  - Treatment Options for Dementia with Lewy Bodies: A Network Meta-Analysis of 
      Randomised Control Trials.
PG  - 521-534
LID - 10.1007/s40120-020-00198-0 [doi]
AB  - INTRODUCTION: Dementia with Lewy bodies (DLB) is the third most common type of 
      dementia after Alzheimer's disease (AD) and vascular dementia. Treatment is 
      targeted at specific disease manifestations/symptoms. While donepezil is approved 
      for the treatment of DLB in Japan, to date no other treatment has been approved 
      for this indication anywhere in the world. Notwithstanding, many of the 
      medications that are approved for AD are widely used in the treatment of DLB with 
      varying degrees of success. Consequently, clinical evidence is limited, and there 
      is a need to understand the comparative efficacy and safety of currently used 
      therapies for DLB. The aim of this study was to conduct a network meta-analysis 
      (NMA) to evaluate the outcomes of the available treatment options based on 
      currently used trial endpoints. METHODS: Using data from a previously published 
      systematic review, we conducted an NMA to investigate the efficacy and safety of 
      treatments in patients with DLB. Networks were based on change from baseline of 
      efficacy endpoints (Mini-Mental State Examination; Neuropsychiatric Inventory; 
      Unified Parkinson's Disease Rating Scale) and rate of safety events (overall 
      adverse events [AEs]; discontinuations; discontinuations due to AEs; psychiatric 
      events). RESULTS: Focused around a common treatment option of placebo, the NMA 
      comprised studies on donepezil, rivastigmine, memantine and quetiapine. Donepezil 
      3 mg, 5 mg and 10 mg doses were compared against each other and placebo. Overall, 
      donepezil consistently performed better than the alternative treatments when 
      compared to placebo for all efficacy and safety endpoints. However, the small 
      sample size and/or heterogeneity of the studies led to uncertainty, resulting in 
      no statistically significant differences favouring any treatment above another or 
      placebo. CONCLUSION: Despite the lack of statistical significance, when assessing 
      the efficacy and safety outcomes for each drug in the evidence network, donepezil 
      appeared to have a more favourable overall benefit/risk profile for patients with 
      DLB. Further comparative trials are required to improve understanding of the true 
      difference between existing and potential future treatment options.
FAU - Tahami Monfared, Amir A
AU  - Tahami Monfared AA
AD  - Eisai Inc., Woodcliff Lake, NJ, USA. amir_tahami@eisai.com.
AD  - Epidemiology, Biostatistics, and Occupational Health, McGill University, 
      Montreal, QC, Canada. amir_tahami@eisai.com.
FAU - Desai, Mitesh
AU  - Desai M
AD  - Adelphi Values, Bollington, UK.
FAU - Hughes, Robert
AU  - Hughes R
AD  - Adelphi Values, Bollington, UK.
FAU - Lucherini, Stefano
AU  - Lucherini S
AD  - Adelphi Values, Bollington, UK.
FAU - Yi, Yunni
AU  - Yi Y
AD  - Adelphi Values, Bollington, UK.
FAU - Perry, Richard
AU  - Perry R
AD  - Adelphi Values, Bollington, UK.
LA  - eng
PT  - Journal Article
DEP - 20200603
PL  - New Zealand
TA  - Neurol Ther
JT  - Neurology and therapy
JID - 101637818
PMC - PMC7606367
OTO - NOTNLM
OT  - Dementia with Lewy bodies
OT  - Donepezil
OT  - Memantine
OT  - Mini-Mental State Examination
OT  - Network meta-analysis
OT  - Neuropsychiatric Inventory
OT  - Quetiapine
OT  - Rivastigmine
OT  - Unified Parkinson's Disease Rating Scale
COIS- Eisai employed Amir A. Tahami Monfared, who played a significant part in study 
      design, data collection, data analysis, data interpretation and writing of the 
      report. Mitesh Desai, Stefano Lucherini, Robert Hughes, Yunni Yi and Richard 
      Perry have nothing to disclose.
EDAT- 2020/06/05 06:00
MHDA- 2020/06/05 06:01
PMCR- 2020/06/03
CRDT- 2020/06/05 06:00
PHST- 2020/04/03 00:00 [received]
PHST- 2020/06/05 06:00 [pubmed]
PHST- 2020/06/05 06:01 [medline]
PHST- 2020/06/05 06:00 [entrez]
PHST- 2020/06/03 00:00 [pmc-release]
AID - 10.1007/s40120-020-00198-0 [pii]
AID - 198 [pii]
AID - 10.1007/s40120-020-00198-0 [doi]
PST - ppublish
SO  - Neurol Ther. 2020 Dec;9(2):521-534. doi: 10.1007/s40120-020-00198-0. Epub 2020 
      Jun 3.