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SYSTEMATIC REVIEW article

Front. Pharmacol.
Sec. Neuropharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1451032
This article is part of the Research Topic Challenges and Opportunities with the Rollout of New Alzheimer’s Disease Drugs: A Focus on Non-Alzheimer's Dementia View all articles

Pharmacological Treatments for Vascular Dementia: A Systematic Review and Bayesian Network Meta-Analysis

Provisionally accepted
Chun Dang Chun Dang 1Qinxuan Wang Qinxuan Wang 1Zhuang Yijia Zhuang Yijia 1Qian Li Qian Li 2Li Feng Li Feng 3Yaoheng Lu Yaoheng Lu 4*Ying Xiong Ying Xiong 5*
  • 1 West China Hospital, Sichuan University, Chengdu, China
  • 2 Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
  • 3 Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
  • 4 Department of General Surgery, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital,, Chengdu, Sichuan Province, China
  • 5 Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Background: Vascular dementia (VaD) is one of the most prevalent, burdensome, and costly forms of dementia. Pharmacological treatment is often the first-line choice for clinicians; however, there is a paucity of comparative information regarding the multiple available drug options. Methods and analysis: A systematic review and network meta-analysis were conducted on randomized trials involving adult patients with VaD, sourced from PubMed, the Cochrane Library, EMBASE, Web of Science, OPENGREY, ClinicalTrials.gov, Wanfang Data, and CNKI. The primary outcomes included changes in Mini-Mental State Examination (MMSE) scores, activities of daily living (ADL) scores, and the incidence of adverse reactions. Efficacy and safety of intervention strategies were comprehensively analyzed using forest plots, cumulative ranking probability curves (SUCRA), and funnel plots, all generated with R software. Results: A total of 194 RCTs comparing 21 different anti-VaD drugs with placebos or no treatment were analysed. Regarding MMSE scores, the five most effective drugs were Butylphthalide, Huperzine A, Edaravone, Rivastigmine, and Memantine. For ADL scores, the top five drugs in efficacy were Huperzine A, Butylphthalide, Tianzhi granule, Nicergoline, and Idebenone. In terms of the incidence of adverse drug reactions, Co-dergocrine Mesylate, Tongxinluo capsule, Butylphthalide, Piracetam, and Oxiracetam demonstrated favourable safety profiles.This study enhances the understanding of the relative benefits and risks associated with various VaD treatments, providing a valuable reference for clinical decision-making.

    Keywords: Bayesian network meta-analysis, Vascular Dementia, Treatment Decision-making, Meta, VAD

    Received: 18 Jun 2024; Accepted: 26 Jul 2024.

    Copyright: © 2024 Dang, Wang, Yijia, Li, Feng, Lu and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yaoheng Lu, Department of General Surgery, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital,, Chengdu, Sichuan Province, China
    Ying Xiong, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.