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Review
. 2015 Jul 28;19(2):pyv086.
doi: 10.1093/ijnp/pyv086.

Cholinesterase Inhibitors for Lewy Body Disorders: A Meta-Analysis

Shinji Matsunaga  1 , Taro Kishi  1 , Ichiro Yasue  2 , Nakao Iwata  2
Affiliations
Review

Cholinesterase Inhibitors for Lewy Body Disorders: A Meta-Analysis

Shinji Matsunaga et al. Int J Neuropsychopharmacol. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Int J Neuropsychopharmacol. 2016 Apr 27;19(10):pyw031. doi: 10.1093/ijnp/pyw031. Int J Neuropsychopharmacol. 2016. PMID: 27207904 Free PMC article. No abstract available.

Abstract

Background: We performed a meta-analysis of cholinesterase inhibitors for patients with Lewy body disorders, such as Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies.

Methods: The meta-analysis included only randomized controlled trials of cholinesterase inhibitors for Lewy body disorders.

Results: Seventeen studies (n = 1798) were assessed. Cholinesterase inhibitors significantly improved cognitive function (standardized mean difference [SMD] = -0.53], behavioral disturbances (SMD = -0.28), activities of daily living (SMD = -0.28), and global function (SMD = -0.52) compared with control treatments. Changes in motor function were not significantly different from control treatments. Furthermore, the cholinesterase inhibitor group had a higher all-cause discontinuation (risk ratio [RR] = 1.48, number needed to harm [NNH] = 14), discontinuation due to adverse events (RR = 1.59, NNH = 20), at least one adverse event (RR = 1.13, NNH = 11), nausea (RR = 2.50, NNH = 13), and tremor (RR = 2.30, NNH = 20).

Conclusions: Cholinesterase inhibitors appear beneficial for the treatment of Lewy body disorders without detrimental effects on motor function. However, a careful monitoring of treatment compliance and side effects is required.

Keywords: Lewy body disorders; Parkinson’s disease; cholinesterase inhibitors; dementia with Lewy bodies; meta-analysis.

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Figures

Figure 1.
Figure 1.
The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flow diagram.
Figure 2.
Figure 2.
Risk of bias assessment.
Figure 3.
Figure 3.
Forest plot of cognitive function (16 comparisons, n = 1889).
Figure 4.
Figure 4.
Funnel plots. (a) Cognitive function. (b) Behavioral disturbance. (c) Motor function.
Figure 5.
Figure 5.
Forest plot of behavioral disturbance (13 comparisons, n = 1832).
Figure 6.
Figure 6.
Forest plot of motor function (15 comparisons, n = 1312).
See this image and copyright information in PMC

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