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Noradrenaline agonists may improve cognition and apathy in patients with Alzheimer’s disease
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Disclosure: David is a Clinical Research Training Fellow funded by the British Medical Research Council. See Surveys for disclosure of relevant financial information for all other authors.
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Drugs targeting the noradrenalinergic system may improve cognition and indifference in patients with dementia or mild cognitive impairment caused by Alzheimer’s disease, but have little effect on attention or episodic memory, studies show. They reported.
Michael CB David, MBBSResearchers and PhD candidates, and colleagues at Imperial College London aimed to assess the efficacy of drugs with predominantly noradrenalinergic effects on cognitive and neuropsychiatric symptoms in AD patients.
From 1980 to December 2021, researchers searched MEDLINE, Embase, and ClinicalTrials.gov and used random effects meta-analysis to generate pooled estimates.
They identified 19 randomized controlled trials (n = 1,811 patients) and conducted a meta-analysis of 10 studies. , 0.03-0.25). The authors reported no significant effect on the measurement of attention (SMD = 0.01; 95% CI, –0.17 to 0.19).
When measuring indifference via a meta-analysis, researchers found a significant positive effect of noradrenaline agonists, including 8 trials (n = 425 patients) (SMD = 0.45; 95% CI, 0.16-0.73). This was consistently observed even after removing the outliers to explain the non-uniformity between studies.
“The diversion of established noradrenaline agonists is most likely to provide an effective treatment for Alzheimer’s disease because of general cognition and indifference,” David and colleagues write. Journal of Neurology, Neurosurgery & Psychiatry.. “But before designing future clinical trials, there are several factors that need to be considered: targeting the appropriate patient subgroup, with the dose-effects of individual drugs and other therapies. It involves understanding the interactions between people, minimizing risk and maximizing therapeutic effectiveness. “
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