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A Systematic Review and Meta-Analysis of Randomized Control Trials to Check Role of Non-Steroidal Anti-inflammatory Drugs as Protective Factor in Alzheimer Disease Subjects

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Advances in Alzheimer's Disease 2023年第1期12卷 1-16页

作者： Akash Asthana shashank tripathi Rachna Agarwal Department of Statistics University of Lucknow Lucknow India Department of Neurochemistry Institute of Human Behavior and Allied Sciences New Delhi India

Background: Alzheimer’s disease is the major neurodegenerative disease, affecting more than two third cases of dementia in the world. NSAIDs are widely used anti-inflammatory analgesic agents representing 7.7% of worldwide prescriptions of which 90% are in patients over 65 years old. Based on mixed findings observed by different RCTs, a systematic review and meta-analysis were conducted to develop a better understanding of the protective role of Non-steroidal anti-inflammatory drugs (NSAIDs) in AD. Methods: Database search was Pubmed, WebScience, and Embase. RCTs investigating the effect of NSAIDs on AD or test scores assessing cognitive function in people without AD at baseline were included. Three indicators were MMSE Score, ADAS-cog score, and CDR-sob. 10 studies were included in the present Meta-analysis. Results: For the ADAS-cog score, the pooled effect size was -0.31 with 95% CI -0.06 to 0.02, which was statistically significant (p = 0.03). MMSE score difference, the pooled effect size was -0.06 with 95% CI -0.22 to 0.10, which was statistically insignificant (p-value = 0.47). For the MMSE average score, the pooled effect size was -0.002 with 95% CI -0.03 to 0.07, which was statistically insignificant (p-value = 0.87). For the CDR-sob score difference, the pooled effect size calculated using the random effect model was -0.06 with 95% CI -0.39 to 0.05 which was statistically insignificant (p = 0.14). For CDR-sob average score, the pooled effect size calculated using the random effect model was 0.21 with 95% CI -0.09 to 0.51, which was statistically insignificant (p-value = 0.17). Conclusion: Present Meta-analysis shows that NSAIDs in general are not effective in the treatment of AD. They also have no protective effect against the development of AD on their sustained use.

关键词： NSAIDs Alzheimer’s Disease Meta-Analysis Hazard Ratio

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Non-Steroidal Anti-Inflammatory Drugs as Protective Factor in Alzheimer’s Diseases: A Systematic Review and Meta-Analysis Protocol

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Advances in Alzheimer's Disease 2023年第2期12卷 17-28页

作者： Akash Asthana Rachna Agarwal shashank tripathi Department of Statistics University of Lucknow Lucknow India Department of Neurochemistry Institute of Human Behavior and Allied Sciences New Delhi India

Introduction: NSAIDs inhibit COX-2, which is responsible for regulating neurons leading to neurodegeneration in Alzheimer’s disease. Alzheimer’s disease is a neurodegenerative disease affecting the geriatric population, as it affects more than two third cases of dementia in the sphere. Results obtained from experimental and observational studies were unclear regarding the protective role of NSAIDs in AD, therefore this justifies the need for meta-analysis. Methods: Database search was PubMed, Web of Science, and Embase. Experimental studies and Observational studies investigating the effect of NSAIDs on AD. For experimental studies indicators used were MMSE score, ADAS-cog score, CDR-sob score, NPI score, and Hazard ratio. Similarly for Observational studies, Odds Ratio and Relative Risk are used. Results: As this is the study protocol, therefore it is not possible to write the results of the study in the study protocol. There is a total of 06 (MMSE, ADAS-cog, CDR-sob, HR, RR, and OR) indicators used in the study, so 06 results will be obtained showing the pooled effect size which will indicate the use of NSAIDs as a protective factor for Alzheimer’s disease. Discussion: The present systematic review will improve the understanding of the relative efficacies of NSAIDs in AD and possibly guide clinical practices by providing the current best evidence on the efficacy of various regimens of NSAIDs in the management of AD subjects. Conclusion: Conclusion can be drawn only after the final meta-analysis using three study design (RCT, Cohort and Case-control study designs) and six indicators.

关键词： Alzheimer’s Disease NSAIDs Meta-Analysis RCT OR RR

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