Donepezil, rivastigmine, galantamine and memantine for ...

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This is an update report for donepezil, rivastigmine and galantamine (the first being completed in 2000) 1 and a new report for memantine. The aim of the review is (1) to provide a review of the clinical effectiveness and cost-effectiveness of the symptomatic treatments of donepezil, rivastigmine and galantamine for people suffering from mild to moderately severe Alzheimer’s disease (AD); and (2) to provide a review of the Chapter 1 Aim of the review © Queen’s Printer and Controller of HMSO 2006. All rights reserved. Health Technology Assessment 2006; Vol. 10: No. 1 clinical effectiveness and cost-effectiveness of memantine for the symptomatic treatment of people suffering from moderately severe to severe AD. Potential benefits may be demonstrated on measures of global functioning, cognition, function, behaviour and mood and health-related quality of life (QoL). These drugs may also improve the ability to remain independent, reduce the likelihood of admission to residential/nursing care and improve carer health-related QoL. 1
Page 1 and 2: Health Technology Assessment 2006;
Page 3 and 4: The clinical and cost-effectiveness
Page 5 and 6: Objectives: To provide an update re
Page 7 and 8: List of abbreviations .............
Page 9 and 10: AChEI acetylcholinesterase inhibito
Page 11 and 12: Epidemiology and background Alzheim
Page 13: Galantamine Five published economic
Page 18 and 19: 4 Background criteria have been est
Page 20 and 21: 6 Background rates for those aged 6
Page 22 and 23: 8 Background Description of the int
Page 24 and 25: 10 Methods applied by one reviewer
Page 27 and 28: Donepezil Quantity and quality of r
Page 29 and 30: TABLE 3 Characteristics of included
Page 31 and 32: TABLE 3 Characteristics of included
Page 33 and 34: TABLE 5 ADAS-cog for donepezil coll
Page 35 and 36: ADAS-cog of -1.7 (SEM 0.45) and tho
Page 37 and 38: Comparison: Outcome: Study 03 Donep
Page 39 and 40: Three trials 41,44,54 were two-arm
Page 41 and 42: Comparison: Outcome: Study 05 Donep
Page 43 and 44: TABLE 9 CDR-SB for donepezil © Que
Page 45 and 46: GBS prepared by the study authors f
Page 47 and 48: Carer mental health and burden One
Page 49 and 50: TABLE 10 Adverse events for donepez
Page 51 and 52: TABLE 10 Adverse events for donepez
Page 53 and 54: TABLE 11 Withdrawals due to adverse
Page 55 and 56: TABLE 13 Characteristics of include
Page 57 and 58: TABLE 15 ADAS-cog for rivastigmine
Page 59 and 60: TABLE 16 MMSE for rivastigmine BVRT
Page 61 and 62: GDS. The GDS was used as an outcome
Page 63 and 64: Compliance Rösler and colleagues 5
Page 65 and 66:
TABLE 23 Withdrawals due to adverse
Page 67 and 68:
TABLE 24 Characteristics of include
Page 69 and 70:
TABLE 25 Quality assessment table f
Page 71 and 72:
Review: Comparison: Outcome: 01 6 m
Page 73 and 74:
TABLE 27 ADAS-cog: responders for g
Page 75 and 76:
CIBIC-plus scale showed the benefit
Page 77 and 78:
Behaviour and mood NPI Two publishe
Page 79 and 80:
TABLE 32 Withdrawals due to adverse
Page 81 and 82:
TABLE 33 Characteristics of include
Page 83 and 84:
TABLE 37 Adverse events for donepez
Page 85 and 86:
● Rates of mild to moderate adver
Page 87 and 88:
TABLE 41 CIBIC-plus for memantine g
Page 89 and 90:
TABLE 45 Additional outcome measure
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study. 71 Most adverse events were
Page 93 and 94:
Anumber of systematic reviews of th
Page 95 and 96:
Introduction The aim of this sectio
Page 97 and 98:
system or social services). 56 In o
Page 99 and 100:
TABLE 49 Outline detail on the mode
Page 101 and 102:
outcome. The incremental cost per e
Page 103 and 104:
Cost-effectiveness acceptability cu
Page 105 and 106:
Economic evaluations of rivastigmin
Page 107 and 108:
treatment should be the same as tho
Page 109 and 110:
community-based care costs) were ca
Page 111 and 112:
TABLE 52 Characteristics of economi
Page 113 and 114:
patients are seen to discontinue ga
Page 115 and 116:
galantamine treatment based on inpu
Page 117 and 118:
TABLE 53 Characteristics of economi
Page 119 and 120:
Launois and colleagues report that
Page 121 and 122:
Reisberg and colleagues. 72 These p
Page 123 and 124:
TABLE 55 Sectors involved in caring
Page 125 and 126:
TABLE 58 Summary of average weekly
Page 127 and 128:
Supporting data on the weekly cost
Page 129 and 130:
Health state utilities/values for A
Page 131 and 132:
on a sample (n = 178) of AD patient
Page 133 and 134:
epresentation of disease progressio
Page 135 and 136:
TABLE 67 AHEAD model predictive ris
Page 137 and 138:
Mortality data Within a model of di
Page 139 and 140:
TABLE 71 Estimate of annual NHS and
Page 141 and 142:
Probability cost-effective, increme
Page 143 and 144:
to stochastic data input, to addres
Page 145 and 146:
SHTAC analysis of cost-effectivenes
Page 147 and 148:
general clinical trial literature (
Page 149 and 150:
effectiveness of rivastigmine, 90-9
Page 151:
conservative effectiveness scenario
Page 155:
If drug therapy stabilised some of
Page 159 and 160:
Statement of principal findings The
Page 161 and 162:
the cost-effectiveness of rivastigm
Page 163 and 164:
placebo groups but care should be t
Page 165:
We are very grateful to our three a
Page 168 and 169:
154 References 22. Di Carlo A, Bald
Page 170 and 171:
156 References 69. Wilkinson DG, Pa
Page 172 and 173:
158 References 120. Kavanagh S, Sch
Page 174 and 175:
160 References 176. Aneshensel CS,
Page 178 and 179:
Members Chair, Professor Tom Walley
Page 180 and 181:
Members Chair, Professor Bruce Camp
Page 183:
Feedback The HTA Programme and the
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