Rapid Health Technology Assessment of Donepezil in the Treatment of Alzheimer ’s Disease / 中国药房

ABSTRACT

OBJECTIVE：To evaluate the efficacy ，safety and econom y of donepezil in the treatment of Alzheimer ’s disease （AD），so as to provide evidence-based evidence for clinical rational drug use. METHODS ：Retrieved from PubMed ，Embase，the Cochrane Library ，CNKI，Wanfang database ，CBM and health technology assessment （HTA）organization websites ，systematic review/Meta-analysis，economic evaluation and HTA reports about donepezil in the treatment of AD were collected during the inception to Feb. 2021. Data extraction and quality evaluation were carried out for the literature that met the inclusion and exclusion criteria，and the research results were summarized and analyzed qualitatively. RESULTS ：A total of 26 studies were included ， including 15 systematic reviews/Meta-analysis ，and 11 economic studies ；HTA reports were not included. The results showed that in terms of effectiveness ，compared with placebo ，donepezil could significantly improve the cognitive function ，activity of daily life，mental behavior and overall function of AD patients （P＜0.05）；compared with rivastigmine ，donepezil could significantly improve cognitive function of AD patients （P＜0.05）；compared with galantamine ，donepezil could significantly improve cognitive function and overall function （P＜0.05），but there was no statistical significance in terms of improving mental behavioral symptoms（P＞0.05）；there was no statistical significance between donepezil and memantine in improving cognitive function ， psychobehavioral symptoms and activities of daily living in AD patients （P＞0.05），but donepezil was weaker than memantine in overall functional （P＜0.05）. In terms of safety ，there was no significant difference in the tolerance and mortality in patients using donepezil and placebo （P＞0.05）；donepezil was better tolerated than rivastigmine and galantamine （P＜0.05）；there was no significant difference in the incidence of ADR for donepezil compared with placebo ， metamine and other non-placebo mail：15201008872@163.com controlled drugs （P＞0.05）. Economic studies showed that # compared with rivastigmine ，placebo and no AD-related drug treatment，donepezil could prolong quality adjusted life years （QALY）and saved medical costs ，which was more cost-effective. Compared with conventional treatment for basic disease and memantine，although donepezil could prolong QALY ，whether it had economic advantages still needed to confirmed in combination with national or regional health resource conditions. CONCLUSIONS ：Donepezil is ralatively effective ，safe and economical in the treatment of AD.