医学
二十碳五烯酸
耐受性
随机对照试验
安慰剂
痴呆
内科学
中止
多不饱和脂肪酸
不利影响
欧米茄3脂肪酸
优势比
精神科
六烯酸
疾病
脂肪酸
病理
生物
替代医学
生物化学
作者
Ping‐Tao Tseng,Bing‐Syuan Zeng,Mein‐Woei Suen,Yi‐Cheng Wu,Christoph U. Correll,Bing‐Yan Zeng,John S. Kuo,Yen‐Wen Chen,Tien‐Yu Chen,Yu‐Kang Tu,Pao‐Yen Lin,André F. Carvalho,Brendon Stubbs,Dian‐Jeng Li,Chih‐Sung Liang,Chih‐Wei Hsu,Cheuk‐Kwan Sun,Yu‐Shian Cheng,Pin‐Yang Yeh,Ming‐Kung Wu,Yow‐Ling Shiue,Kuan‐Pin Su
标识
DOI:10.1016/j.bbi.2023.04.017
摘要
Alzheimer's dementia (AD) is a major contributor to global disability, and effective therapies to modify disease progression are currently lacking. The neuro-inflammatory theory is a potential etiology underlying this neurodegenerative disease. Previous randomized, controlled trials (RCTs) have provided inconclusive results regarding efficacy of omega-3 polyunsaturated fatty acids (PUFAs) regimens, which might provide anti-inflammatory benefits in the management of AD, in improving cognitive function among participants with AD. The objective of this frequentist-model based network meta-analysis (NMA) was to evaluate the potential advantages of omega-3 PUFAs and currently FDA-approved medications for AD on overall cognitive function in AD individuals. The primary outcomes were: (1) changes in cognitive function, and (2) acceptability, which refers to all-cause discontinuation. Additionally, secondary outcomes included quality of life, behavioral disturbances and safety/tolerability, which was assessed through the frequency of any reported adverse event. This NMA included 52 RCTs (6 with omega-3 PUFAs and 46 with FDA-approved medications) involving 21,111 participants. The results showed that long-term high-dose (1500-2000 mg/day) of eicosapentaenoic acid (EPA)-dominant omega-3 PUFAs augmented with anti-oxidants had the highest potential for cognitive improvement among all investigated treatments [standardized mean difference = 3.00, 95% confidence intervals (95 %CIs) = 1.84-4.16]. Compared to placebo, omega-3 PUFAs had similar acceptability [odds ratio (OR) = 0.46, 95 %CIs = 0.04 to 5.87] and safety profiles (OR = 1.24, 95 %CIs = 0.66 to 2.33)o. These findings support the potential neurotherapeutic effects of high dosage EPA-dominant omega-3 PUFAs for the amelioration of cognitive decline in patients with AD. Future large-scale, long-term RCTs should focus on different dosages of EPA-dominant omega-3 PUFAs regimens on improving cognitive dysfunction in patients with AD at different levels of inflammatory status and psychopathology.
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