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Meta-Analysis
. 2022 Aug 5;101(31):e29307.
doi: 10.1097/MD.0000000000029307.

A systematic review of the efficacy of donepezil hydrochloride combined with nimodipine on treating vascular dementia

Qiang Yang  1 , Jia Liu  2 , Kai-Lin Huang  2 , Guang-Yao Wang  3 , Mi-Yuan Wang  4 , Ai-Hua Tan  2   5   6 , Si-Miao Ran  5   6
Affiliations
Meta-Analysis

A systematic review of the efficacy of donepezil hydrochloride combined with nimodipine on treating vascular dementia

Qiang Yang et al. Medicine (Baltimore). .

Abstract

Background: Vascular dementia (VaD) is a comprehensive syndrome related to the damage of cognitive function and various cerebral vascular illnesses. VaD is also generally recognized as the second most common type of dementia after Alzheimer disease, contributing to 30% of the dementia population in Asia and developing countries. The ability of donepezil hydrochloride and nimodipine had been respectively proven in improving cognitive function in vascular dementia. However, whether the combined application of both drugs contribute to better efficacy remains as a research hotspot. Studies had shown definite satisfactory result with such combination, however evidence-based evaluation of the efficacy is still lacking. Therefore, meta-analysis is employed in this study to evaluate the efficacy and safety of using donepezil hydrochloride combined with nimodipine in treating VaD to provide references for clinical treatments. The efficacy of donepezil hydrochloride combined with nimodipine on treating vascular dementia is systematically reviewed to provide evidence-based references for clinical applications.

Methods: Both Chinese and English databases were searched from the start till August, 2020 for any RCT regarding the combined use of the 2 drugs in treating vascular dementia. Two investigators would later evaluate and screened out research and data based on an improved Jaded scale. Software Rev Man 5.3.0 was employed to carry out meta-analysis on clinical effificacy, mini-mental state examination (MMSE) ratings, activity of daily living (ADL) ratings, and clinical dementia scale (CDR) ratings.

Results: Donepezil hydrochloride combined with nimodipine had demonstrated satisfactory efficacy on the treatment of vascular dementia. Improvements were namely spotted on MMSE scale, ADL scale, and CDR scale, with the utmost efficacy by 12 weeks after intervention.

Conclusions: Donepezil hydrochloride combined with nimodipine had good efficacy in the treatment of patients with vascular dementia, mainly in terms of improving the Simple MMSE scores, the ability to use daily living scale (ADL) scores and the CDR, and the best results were obtained after 12 weeks of intervention. Such conclusion should be cautiously evaluated.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow chart of literature screening.
Figure 2.
Figure 2.
Risk of bias graph.
Figure 3.
Figure 3.
Risk of bias summary.
Figure 4.
Figure 4.
The forest plot of MMSE. MMSE = mini-mental state examination.
Figure 5.
Figure 5.
The forest plot of MMSE (subgroup analysis by duration of treatment: 12, 8, and 4 weeks). MMSE = mini-mental state examination.
Figure 6.
Figure 6.
Sensitivity analysis of MMSE. MMSE = mini-mental state examination.
Figure 7.
Figure 7.
The forest plot of ADL. ADL = activity of daily living.
Figure 8.
Figure 8.
The forest plot of ADL (subgroup analysis by duration of treatment: 12, 8, and 4 weeks). ADL = activity of daily living.
Figure 9.
Figure 9.
Sensitivity analysis of ADL. ADL = activity of daily living.
Figure 10.
Figure 10.
The forest plot of CDR. CDR = clinical dementia scale.
Figure 11.
Figure 11.
The forest plot of CDR (subgroup analysis by duration of treatment 12, 8, and 4 weeks). CDR = clinical dementia scale.
Figure 12.
Figure 12.
Sensitivity analysis of CDR. CDR = clinical dementia scale.
Figure 13.
Figure 13.
The forest plot of curative effect.
Figure 14.
Figure 14.
The funnel plot of MMSE scale scores before and after treatment. MMSE = mini-mental state examination.
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