Abstract：
Lewy body dementia (LBD) is the second most common neurodegenerative dementia, and it causes earlier mortality and more morbidity than Alzheimer\'s disease. Reviewing current evidence on its pharmacological management is essential for developing evidence-based clinical guidelines, and for improving the quality of its clinical care. Hence, we systematically reviewed all studies that investigated the efficacy of any medication for managing various symptoms of LBD.
We identified eligible studies by searching 15 databases comprehensively. We completed quality assessment, extracted relevant data, and performed GRADE assessment of available evidence. We conducted meta-analyses when appropriate (PROSPERO:CRD42020182166).
We screened 18,884 papers and included 135 studies. Our meta-analyses confirmed level-1 evidence for Donepezil\'s efficacy of managing cognitive symptoms of dementia with Lewy bodies (DLB) (SMD = 0.63; p < 0.001) and Parkinson\'s Disease Dementia (PDD) (SMD = 0.43; p < 0.01), and managing hallucinations in DLB (SMD=-0.52; p = 0.02). Rivastigmine and Memantine have level-2 evidence for managing cognitive and neuropsychiatric symptoms of DLB. Olanzapine and Yokukansan have similar evidence for managing DLB neuropsychiatric symptoms. Level-2 evidence support the efficacy of Rivastigmine and Galantamine for managing cognitive and neuropsychiatric symptoms of PDD.
We list evidence-based recommendations for the pharmacological management of DLB and PDD, and propose specific clinical guidelines for improving their clinical management.
Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2032601 .
We identified eligible studies by searching 15 databases comprehensively. We completed quality assessment, extracted relevant data, and performed GRADE assessment of available evidence. We conducted meta-analyses when appropriate (PROSPERO:CRD42020182166).
We screened 18,884 papers and included 135 studies. Our meta-analyses confirmed level-1 evidence for Donepezil\'s efficacy of managing cognitive symptoms of dementia with Lewy bodies (DLB) (SMD = 0.63; p < 0.001) and Parkinson\'s Disease Dementia (PDD) (SMD = 0.43; p < 0.01), and managing hallucinations in DLB (SMD=-0.52; p = 0.02). Rivastigmine and Memantine have level-2 evidence for managing cognitive and neuropsychiatric symptoms of DLB. Olanzapine and Yokukansan have similar evidence for managing DLB neuropsychiatric symptoms. Level-2 evidence support the efficacy of Rivastigmine and Galantamine for managing cognitive and neuropsychiatric symptoms of PDD.
We list evidence-based recommendations for the pharmacological management of DLB and PDD, and propose specific clinical guidelines for improving their clinical management.
Supplemental data for this article can be accessed online at https://doi.org/10.1080/13607863.2022.2032601 .
摘要：
未经证实：路易体痴呆（LBD）是第二常见的神经退行性痴呆，它比阿尔茨海默病导致更早的死亡率和更高的发病率。回顾当前关于其药理管理的证据对于制定循证临床指南至关重要。并提高其临床护理质量。因此，我们系统回顾了所有研究任何药物治疗LBD各种症状的疗效.
UNASSIGNED：我们通过全面检索15个数据库确定了符合条件的研究。我们完成了质量评估，提取相关数据，并对现有证据进行了等级评估。我们在适当的时候进行了荟萃分析(PROSPERO：CRD42020182166)。
未经评估：我们筛选了18,884篇论文，纳入了135项研究。我们的荟萃分析证实了多奈哌齐治疗路易体痴呆（DLB）（SMD=0.63;p<0.001）和帕金森病痴呆（PDD）（SMD=0.43;p<0.01）的认知症状的疗效的1级证据，并管理DLB中的幻觉（SMD=-0.52；p=0.02）。Rivastigmine和Memantine具有2级证据来管理DLB的认知和神经精神症状。奥氮平和Yokukansan在治疗DLB神经精神症状方面有相似的证据。2级证据支持Rivastigmine和Galantamine用于治疗PDD的认知和神经精神症状的功效。
UASSIGNED：我们列出了DLB和PDD药物管理的循证建议，并提出改进其临床管理的具体临床指南。
本文的补充数据可通过https://doi.org/10.1080/13607863.202.2032601在线访问。
UNASSIGNED：我们通过全面检索15个数据库确定了符合条件的研究。我们完成了质量评估，提取相关数据，并对现有证据进行了等级评估。我们在适当的时候进行了荟萃分析(PROSPERO：CRD42020182166)。
未经评估：我们筛选了18,884篇论文，纳入了135项研究。我们的荟萃分析证实了多奈哌齐治疗路易体痴呆（DLB）（SMD=0.63;p<0.001）和帕金森病痴呆（PDD）（SMD=0.43;p<0.01）的认知症状的疗效的1级证据，并管理DLB中的幻觉（SMD=-0.52；p=0.02）。Rivastigmine和Memantine具有2级证据来管理DLB的认知和神经精神症状。奥氮平和Yokukansan在治疗DLB神经精神症状方面有相似的证据。2级证据支持Rivastigmine和Galantamine用于治疗PDD的认知和神经精神症状的功效。
UASSIGNED：我们列出了DLB和PDD药物管理的循证建议，并提出改进其临床管理的具体临床指南。
本文的补充数据可通过https://doi.org/10.1080/13607863.202.2032601在线访问。
