[Doubtful evidence for the use of the cholinesterase inhibitor donepezil in patients with dementia--a systematic review].
OBJECTIVE
Objective of this systematic review is to determine the level of scientific evidence for the use of Donepezil in Alzheimer's Disease.


METHODS
Ten randomised controlled double-blind trials testing Donepezil versus Placebo were identified in MEDLINE and EMBASE. All ten trials were included in this systematic review. Following a detailed catalogue of criteria the methodological standard of the ten trials was assessed.


RESULTS
The authors of eight trials postulated statistically significant differences in favour of Donepezil. Unfortunately, the methodological standard of all studies was insufficient. The methodological shortcomings are discussed in detail.


CONCLUSIONS
With regard to severe methodological deficiencies the evidence for the use of Donepezil in moderate to severe Alzheimer's Disease is lacking. But even if the trials had been conducted in a methodologically correct way the clinical relevance of the postulated positive results would have to be questioned.
Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf. kaduszki@uke.uni-hamburg.de
H
H
Kaduszkiewicz
H-P
HP
Beck-Bornholdt
H
H
van den Bussche
T
T
Zimmermann
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design
D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil