Amir Abbas Tahami Monfared, Genevieve Meier, Richard Perry, Darren Joe
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引用次数: 0
摘要
导言：据具体估计，相当一部分痴呆症可归因于路易体痴呆症（DLB）--一种最常见的进行性痴呆症；然而，有关这种疾病的文献却很少。我们的目的是研究现有证据，以便更好地了解其治疗前景、临床管理和疾病负担：系统性文献综述收集了所有关于随机对照试验（RCT）、流行病学、疾病进展和经济数据的 DLB 研究报告。另外还进行了一次有针对性的文献综述，收集了有关该疾病的临床管理和生活质量（QoL）的研究报告。发表日期仅限于 2007 年 1 月 1 日至 2018 年 3 月 26 日，但研究性临床试验除外，对其没有时间限制：在初步确定的 3486 项研究中，有 55 项研究符合纳入条件。这些研究主要来自欧洲（29 项）、美国（9 项）和日本（8 项）。迷你精神状态检查和神经精神量表评分是研究性临床试验中最常报告的临床结果（14 项）。临床试验中最常见的干预措施是多奈哌齐和美金刚。与阿尔茨海默病（AD）患者相比，DLB 患者在疗效和安全性、认知障碍、存活率和 QoL 方面的结果通常较差。此外，DLB 患者的住院率和护理成本也较高。此外，目前仅有少数共识指南。其中，只有一套指南（DLB 联合会）是专门针对 DLB 制定的：数据的匮乏表明这一治疗领域的需求尚未得到满足。尽管有几项研究对 DLB 的临床和病理方面进行了调查，但有关痴呆症患者医疗保健使用情况的共识指南和研究主要集中在 AD 方面。此外，大多数研究结果都是与 AD 进行比较得出的：Eisai Inc.
Burden of Disease and Current Management of Dementia with Lewy Bodies: A Literature Review.
Introduction: A significant proportion of dementia is concretely estimated to be attributable to dementia with Lewy bodies (DLB)-one of the most common types of progressive dementia; however, there is a paucity of literature on this disease. We aimed to examine available evidence to gain a better understanding of its treatment landscape, clinical management, and disease burden.
Methods: A systematic literature review captured any DLB studies that report on randomised controlled trials (RCTs), epidemiology, disease progression, and economic data. An additional targeted literature review captured studies reporting on clinical management and quality of life (QoL) in this disease. Publication date was limited to 1 January 2007-26 March 2018, with the exception for RCTs, where no time restrictions were applied.
Findings: Of the 3486 studies initially identified, 55 studies were eligible for inclusion. The studies were mainly from Europe (n = 29), the USA (n = 9), and Japan (n = 8). Mini-Mental State Examination and Neuropsychiatric Inventory scores were the most commonly reported clinical outcomes in RCTs (n = 14). The most frequently identified interventions reported in RCTs were donepezil and memantine. Patients with DLB typically reported worse outcomes in relation to efficacy and safety, cognitive impairment, survival, and QoL compared with those with Alzheimer's disease (AD). Additionally, patients with DLB were associated with higher hospitalisation rates and cost of care. Furthermore, there is a reliance on a small number of consensus guidelines. Of these, only one set of guidelines (DLB Consortium) was developed specifically for DLB.
Conclusion: The paucity of data indicates an unmet need in this therapy area. Although several studies look into the clinical and pathological aspects of DLB, consensus guidelines and studies on healthcare utilisation in patients with dementia have largely focused on AD. Additionally, most of the findings were made in comparison with AD.
期刊介绍：
The Norwegian Journal of Geology publishes high-quality, fully peer-review papers from all geoscientific disciplines. Papers are commonly based on regional studies and should emphasise the development of understanding of fundamental geological processes. More specialised papers can also be submitted, but should be written in a way that is easily understood by nonspecialists, and illustrate the progress being made within that specific topic in geosciences. We also encourage initiatives for thematic issues within the scope of the Journal.
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