Table 1.
Summary of published meta-analysis data of vascular dementia treatment clinical trials
| Treatment | Number of studies | Subjects | Duration | Benefit | Side effects | References |
|---|---|---|---|---|---|---|
| Memantine | 2 studies
Mild to moderate VaD |
815 | 28 weeks | Improvement: Cognition (ADAS-cog)
Behavior (NOSGER disturbing behavior scale) No change: Global rating (CGI, CIBIC-plus, CGIC) ADLs (NOSGER self-care) |
No difference in those who had at least one adverse event |
Areosa et al 2005 Orgogozo et al 2002 Wilcock et al 2002 |
| Galantamine | 1 study
VaD + AD with cerebrovascular disease |
449–543 | 24 weeks | Improvement: Cognition (ADAS-cog)
Global rating (CIBIC-plus) Behavior (NPI) ADLs (ADCS-ADL) |
Higher rates of withdrawals, withdrawals due to adverse event, total number of patients with at least one adverse event, and rates of nausea/vomiting.
No difference in number of deaths |
Craig and Birks 2006 Bullock et al 2004 |
| 1 study
VaD |
786 | 26 weeks | Improvement: Cognition (ADAS-cog)
Functional ability (DAD) No change: Global rating (CIBIC-plus) Behavior (NPI) ADLs (ADCS-ADL) |
Higher rates of withdrawals due to adverse events
No difference in incidence of adverse events or deaths through 30 days post-trial. |
(GAL-INT-26, 2004 unpublished data) | |
| Donepezil | 2 studies
VaD |
1,219 | 12 weeks and 24 weeks | Improvement: Cognition (ADAS-cog, MMSE)
Global rating (CIBIC-plus, CDR-SB) ADLs (IADLs, ADFACS) |
Significant increase in one side effect or more
No serious adverse effects |
Malouf and Birks 2005 |
| Rivastigmine | 1 study
VaD |
16 | 22 months | Improved: Executive function (Ten point clock drawing)
Behavior (NPI) |
Moretti et al 2002 | |
| Hydergine | 2 studies
VaD |
78 | 6 and 12 weeks | No change: Global rating | Not addressed | Olin et al 2002 and refs. therein |
| 11 studies
Various dementias |
617 | 60 days to 12 months | Improvement: Global rating
Comprehensive rating |
No significant difference in at least one adverse effect | Olin et al 2002 and refs. therein | |
| Nicergoline | 1 study Multi-infarct dementia | 50 | 2 months | Improved: Global rating (CGI) | Fioravanti and Flicker 2001, Saletu et al 1995 | |
| 1 study Multi-infarct dementia | 139 | 6 months | Improved: Memory (MMSE)
Global rating (CGI) |
Herrmann et al 1997 | ||
| 1 study Alzheimer’s dementia + Multi-infarct dementia | 101 | 12 months | Improved: Memory (MMSE)
Global rating (CGI) Behavior (SCAG) |
No significant difference in at least one adverse event during or by end of treatment | Fioravanti and Flicker 2001 and refs. therein | |
| Nimodipine | 3 studies
VaD |
200 | 12 weeks | Improvement: SCAG (n = 130)
Cognition (n = 200) Global function (n = 62) No change: ADLs (n = 65) No change: Cognition (n = 274) Global function (n = 209) Severity of disease (n = 209) ADLs (n = 274) |
Lopez-Arieta and Birks 2002 and refs. therein | |
| 2 studies
VaD |
274 | 24 weeks |
Abbreviations: AD, Alzheimer’s disease; VaD, vascular dementia.