Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Systemic Literature Review Study on the Efficacy and Safety of Novel Alzheimer's Disease Treatments

새로운 알츠하이머 치료제의 안전성 유효성에 관한 체계적 문헌고찰

  • Shinung Park (College of Pharmacy, Institute of Pharmaceutical Sciences, Cha University) ;
  • Harin Chang (College of Pharmacy, Institute of Pharmaceutical Sciences, Cha University) ;
  • HyunSoon Sohn (College of Pharmacy, Institute of Pharmaceutical Sciences, Cha University) ;
  • MiKyong Shim (College of Pharmacy, Institute of Pharmaceutical Sciences, Cha University)
  • 박신웅 (차의과학대학교 약학대학) ;
  • 장하린 (차의과학대학교 약학대학) ;
  • 손현순 (차의과학대학교 약학대학) ;
  • 심미경 (차의과학대학교 약학대학)
  • Received : 2023.12.13
  • Accepted : 2023.12.20
  • Published : 2023.12.31
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Abstract

Background: Innovative Alzheimer's disease drugs received approval in the United States in 2021 and 2023. This study aims to assess the safety and efficacy of these novel treatments, elucidate their mechanisms of action, and compare their impact on cognitive function improvement with approved drugs. Methods: We conducted a comprehensive search of pivotal clinical studies related to Alzheimer's disease treatments in PubMed/Medline, Embase, and the Cochrane Library databases from January 1st, 2020 to December 31st, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 14 studies were included in this systematic review. When compared to the placebo, the new drugs did not exhibit a statistically significant effect on MMSE (Mini-Mental State Examination) (mean difference= -0.04, 95% confidence intervals [CIs]: -0.31, 0.23, N=3662, I2=0%). However, they demonstrated a significant impact on ADAS-cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) (standardized mean difference= -0.15, 95% CIs: -0.2, -0.1, N=6710, I2=17%). When compared to the approved drugs, the new drugs showed a statistically significantly lower effect on MMSE (test for subgroup difference Chi2=23.13, N = 5870, p<0.00001) but showed only a trend of decreased efficacy on ADAS-cog (Chi2=1.16, N = 8670, p=0.28). Conclusion: New drugs yielded diverse clinical endpoint results compared to the placebo, and in comparison to existing approved drugs, they exhibited lower efficacy in improving cognitive function. The safety profile of these new drugs, as reported in clinical trials, was generally well-tolerated.

Keywords

Acknowledgement

데이터 수집에 도움을 준 차의과학대학교 하태욱학생과 이예지학생에게 감사를 드린다.

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