Systematic Evaluation of the Efficacy and Safety of Rivastigmine in Combination with Memantine for Mild to Moderate Alzheimer’s Disease Based on MCMC Algorithm

Abstract

Objective: To systematically analyze the efficacy and safety of rivastigmine combined with memantine in the treatment of mild to moderate Alzheimer’s disease. Methods: In this paper we searched the Chinese and English literature from the date of establishment to August 9, 2022, the included studies met the requirements of rivastigmine combined with memantine for the treatment of Alzheimer’s disease as the trial group, and rivastigmine or memantine alone for the treatment of Alzheimer’s disease was the control group and two researchers performed screening for inclusion, quality evaluation and risk assessment according to the criteria, extracted data and performed statistical analysis of mental status scores and adverse events using generalised linear model Meta-analysis with Markov chain Monte Carlo algorithm. Results: The final study included 8 publications containing 382 patients in the trial group and 376 patients in the control group, for a total of 758 patients. 8 studies had a total MMSE assessment score [weighted mean difference (WMD) = 1.52, 95% CI (0.32–2.73), P = 0.01] and 5 studies had adverse events [dominance ratio (RR) = 1.09, 95% CI (0.92–1.29), P = 0.31], and the results of the reticulated Meta-analysis remained generally consistent with the results of the binary Meta-analysis. Conclusions: The MCMC algorithm has a high degree of accuracy, the combination of rivastigmine and memantine has an advantage over single dosing in improving mental status in mild to moderate Alzheimer’s disease, MMSE scores are influenced by multiple factors such as age and treatment period, and the combination has a better safety and tolerability profile.