CHOLINESTERASE INHIBITORS: A LITERATURE REVIEW OF MEDICATION EFFICACY AND SAFETY FOR ALZHEIMER'S DISEASE

Abstract

Background: With a steady increase of seniors in Canada’s overall population, geriatric-associated illnesses such as Alzheimer’s disease (AD) will continue to rise. AD is a progressive neurodegenerative disorder that causes plaque build-up in the brain and subsequent cerebral atrophy. Currently, there are no treatments marketed to cure the disease, but rather to provide symptomatic relief. Cholinesterase inhibitors have been approved by the US FDA for mild, moderate, and severe AD. Previous studies have investigated the efficacy and safety profile of these medications. Methods: This literature review assessed existing meta-analyses using the PubMed database from 2015- 2020 using search terms ‘cholinesterase inhibitors effectiveness’ and ‘Alzheimer’s’. Outcomes included adverse events associated and change in cognitive function. Results: Five articles met the criteria for the study. All studies concluded there was at least mild or slight improvement on cognitive function with the use of the cholinesterase inhibitors and risks of adverse events were somewhat increased with their use but were likely mild. Conclusion: Given the mild improvement in cognitive functioning coupled with an overall increase in adverse events when compared to placebo, this risk-benefit relationship demonstrates mild evidence in their utility in Alzheimer’s Disease. However, due to the heterogenicity of the available literature, further high quality studies would be ideal to further explore their efficacy in Major Neurocognitive Disorder (NCD) due to Alzheimer’s Disease.