Efficacy of galantamine in treatment of Alzheimer's disease: an update meta-analysis

Alzheimer's disease (AD) is the common cause of dementia affecting the elderly people. Among the various therapeutic approaches, cholinesterase inhibitors (ChEIs) are the first group of compounds that have produced modest improvements in cognitive function of AD patients. Galantamine, one of the ChEIs, has been approved by the US FDA for the treatment of mild or moderate AD. The objective of this study was to systematically evaluate the efficacy and safety of galantamine in AD. We searched for randomized control trials comparing galantamine with placebo in the treatment of patients with AD in the online electronic database of CNKI (China National Knowledge Infrastructure), PubMed, Embase and Medline. The strength of association was estimated by the odds ratio (OR), mean difference (MD) with their 95% confidence interval (CI). The primary outcome measures were Cognitive outcomes on the ADAS-cog subscale (change from baseline). Overall, data were extracted from eight randomized clinical trials and analyzed using standard meta-analysis. The results showed that cognitive effects were significant increased for 24 mg daily in galantamine group when compared with placebo group (MD=-3.15, 95% CI=-3.70 to -2.60, P<0.00001). This effect was also found in the Clinicians' Global Impression of Change scale (OR=1.30, 95% CI=1.06-1.60, P=0.01). Most adverse events were cholinergic in nature and no serious adverse events occurred. Our results suggested that galantamine might be a well-tolerated drug which could play a significant role in improving cognitive performance of patients with AD.