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Galantamine for dementia in people with Down syndrome

  • Review
  • Intervention

Authors


Abstract

Background

Alzheimer's dementia (AD) is the most common form of dementia in people with Down Syndrome (DS). Acetylcholine is a chemical found in the brain that has an important role in memory, attention, reason and language. Galantamine both inhibits the activity of acetylcholinesterase and increases the level of acetylcholine. Galantamine can improve cognitive function and slow the decline of AD in the general population over time. It is important to note that people with DS tend to present with AD at a much younger age than the normal population as well as having subtle differences in physiology (e.g. metabolism and heart rate) and may therefore have different requirements from the general population.

Objectives

To determine the effectiveness and safety of galantamine for people with DS who develop AD.

Search methods

CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS, SCI, SSCI and the NRR were searched up to October 2008. We contacted the manufacturers of galantamine as well as experts in the field, to ask about reports of unpublished or ongoing trials.

Selection criteria

Randomised controlled trials of participants with DS and AD in which treatment with galantamine was administered compared with a placebo group.

Data collection and analysis

No study was identified which met inclusion criteria for this review.

Main results

No study was identified which met inclusion criteria for this review.

Authors' conclusions

As there are no included trials, recommendations cannot be made about galantamine for AD in DS. Well-designed, adequately powered studies are required.

摘要

背景

Galantamine用於罹患失智症之唐氏症個案

阿茲海默氏症(Alzheimer dementia, AD)是在唐氏症(Down Syndrome, DS)個案中,最常見的失智症類型。乙醯膽鹼是一種在大腦中的化學物質,在記憶,注意力,推理以及語言上扮演著重要角色。Galantamine可抑制乙醯膽鹼的活性,並增加乙醯膽鹼的濃度。Galantamine在一般人口中,可以改善認知功能且減慢阿茲海默症隨的衰退。值得注意的是,唐氏症的個案常比一般人口更早發生阿茲海默氏症,並且常有其他的生理方面的微小差異 (如代謝率和心搏速) ,可能因而和一般人口有不同需求。

目標

決定galantamine用於唐氏症個案所發生的阿茲海默氏症之效果及安全性

搜尋策略

我們搜尋了CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, BIOSIS, SCI, SSCI 和 NRR等資料庫至2008年10月的研究論文。我們聯繫galantamine的製造者以及此領域的專家,詢問尚未發表的報告以及正在進行中的試驗。

選擇標準

針對唐氏症合併阿茲海默氏症的患者,接受galantamine治療與接受安慰劑組相比較的隨機對照試驗

資料收集與分析

沒有發現可以符合納入此篇回顧標準的研究。

主要結論

沒有發現可以符合納入此篇回顧標準的研究。

作者結論

由於沒有納入的試驗,無法對galantamine用於罹患阿茲默氏症的唐氏症患者作出建議,需要有完善設計、有充分檢定力的研究。

翻譯人

本摘要由成功大學附設醫院黃惠群翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

Galantamine用於罹患失智症之唐氏症個案:已有報告指出,Galantamine在非唐氏症個案上,對輕到中度的阿茲海默氏症有幫助。然而,唐氏症的個案常比一般人口更早發生阿茲海默氏症,並且也常有其他的生理方面的差異,如體型、代謝率和心搏速,也可能因而和一般人口有不同需求。這次回顧沒有發現任何galantamine用於唐氏症合併阿茲海默氏症患者上的隨機對照試驗,此議題仍需要進一步研究。

Plain language summary

Galantime for dementia in people with Down syndrome

The drug galantamine has been reported to have benefits for people with mild to moderate Alzheimer's disease who do not have Down syndrome. However, people with DS tend to present with AD at a much younger age than the general population as well as being physically different in terms of size, metabolism and heart rate, and may therefore have different requirements. This review identified no randomised controlled trials of galantamine in people with Down syndrome. Further research is needed.