Abstract
Background: Previous clinical studies found that yokukansan has a therapeutic effect on behavioral and psychological symptoms of dementia (BPSD) in dementia patients. Objective: To perform an updated meta-analysis of randomized controlled trials (RCTs) testing yokukansan for patients with BPSD. Methods: Primary efficacy and safety endpoints were BPSD total scores and all-cause discontinuation, respectively. Secondary outcomes were BPSD subscales, cognitive function scores [Mini-mental state examination (MMSE)], activities of daily living (ADL) scores, discontinuation due to adverse events (AEs), and incidences of AEs. Results: Five RCTs with 381 patients with BPSD were included. Compared with controls [placebousual care (UC)], yokukansan significantly decreased BPSD total scores [standardized mean difference (SMD) = -0.32, 95 confidence interval (CI) = -0.53 to -0.11, p = 0.003, I2 = 0, N = 5 studies, n = 361]. Yokukansan was more efficacious in reducing BPSD subscale scores (delusions: SMD = -0.51, 95 CI = -0.98 to -0.04, hallucinations: SMD = -0.54, 95 CI = -0.96 to -0.12, agitation/aggression: SMD = -0.37, 95 CI = -0.60 to -0.15) than placeboUC. However, yokukansan was not superior to placeboUC for BPSD total as well as any subscales scores only in Alzheimer's disease patients. Compared with UC, yokukansan treatment improved ADL scores (SMD = -0.32, 95 CI = -0.62 to -0.01). MMSE scores did not differ between the yokukansan and placeboUC treatment groups. No significant differences were found in all-cause discontinuation, discontinuation due to AEs, and incidences of AEs between yokukansan and placeboUC treatments. Conclusions: Our results suggest that yokukansan is beneficial for the treatment of patients with BPSD and is well-tolerated; it was not beneficial for BPSD total and any subscale scores only in Alzheimer's disease patients.
| Original language | English |
|---|---|
| Pages (from-to) | 635-643 |
| Number of pages | 9 |
| Journal | Journal of Alzheimer's Disease |
| Volume | 54 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 06-09-2016 |
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All Science Journal Classification (ASJC) codes
- Clinical Psychology
- Geriatrics and Gerontology
- Psychiatry and Mental health
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Yokukansan in the Treatment of Behavioral and Psychological Symptoms of Dementia : An Updated Meta-Analysis of Randomized Controlled Trials. / Matsunaga, Shinji; Kishi, Taro; Iwata, Nakao.
In: Journal of Alzheimer's Disease, Vol. 54, No. 2, 06.09.2016, p. 635-643.Research output: Contribution to journal › Article
TY - JOUR
T1 - Yokukansan in the Treatment of Behavioral and Psychological Symptoms of Dementia
T2 - An Updated Meta-Analysis of Randomized Controlled Trials
AU - Matsunaga, Shinji
AU - Kishi, Taro
AU - Iwata, Nakao
PY - 2016/9/6
Y1 - 2016/9/6
N2 - Background: Previous clinical studies found that yokukansan has a therapeutic effect on behavioral and psychological symptoms of dementia (BPSD) in dementia patients. Objective: To perform an updated meta-analysis of randomized controlled trials (RCTs) testing yokukansan for patients with BPSD. Methods: Primary efficacy and safety endpoints were BPSD total scores and all-cause discontinuation, respectively. Secondary outcomes were BPSD subscales, cognitive function scores [Mini-mental state examination (MMSE)], activities of daily living (ADL) scores, discontinuation due to adverse events (AEs), and incidences of AEs. Results: Five RCTs with 381 patients with BPSD were included. Compared with controls [placebousual care (UC)], yokukansan significantly decreased BPSD total scores [standardized mean difference (SMD) = -0.32, 95 confidence interval (CI) = -0.53 to -0.11, p = 0.003, I2 = 0, N = 5 studies, n = 361]. Yokukansan was more efficacious in reducing BPSD subscale scores (delusions: SMD = -0.51, 95 CI = -0.98 to -0.04, hallucinations: SMD = -0.54, 95 CI = -0.96 to -0.12, agitation/aggression: SMD = -0.37, 95 CI = -0.60 to -0.15) than placeboUC. However, yokukansan was not superior to placeboUC for BPSD total as well as any subscales scores only in Alzheimer's disease patients. Compared with UC, yokukansan treatment improved ADL scores (SMD = -0.32, 95 CI = -0.62 to -0.01). MMSE scores did not differ between the yokukansan and placeboUC treatment groups. No significant differences were found in all-cause discontinuation, discontinuation due to AEs, and incidences of AEs between yokukansan and placeboUC treatments. Conclusions: Our results suggest that yokukansan is beneficial for the treatment of patients with BPSD and is well-tolerated; it was not beneficial for BPSD total and any subscale scores only in Alzheimer's disease patients.
AB - Background: Previous clinical studies found that yokukansan has a therapeutic effect on behavioral and psychological symptoms of dementia (BPSD) in dementia patients. Objective: To perform an updated meta-analysis of randomized controlled trials (RCTs) testing yokukansan for patients with BPSD. Methods: Primary efficacy and safety endpoints were BPSD total scores and all-cause discontinuation, respectively. Secondary outcomes were BPSD subscales, cognitive function scores [Mini-mental state examination (MMSE)], activities of daily living (ADL) scores, discontinuation due to adverse events (AEs), and incidences of AEs. Results: Five RCTs with 381 patients with BPSD were included. Compared with controls [placebousual care (UC)], yokukansan significantly decreased BPSD total scores [standardized mean difference (SMD) = -0.32, 95 confidence interval (CI) = -0.53 to -0.11, p = 0.003, I2 = 0, N = 5 studies, n = 361]. Yokukansan was more efficacious in reducing BPSD subscale scores (delusions: SMD = -0.51, 95 CI = -0.98 to -0.04, hallucinations: SMD = -0.54, 95 CI = -0.96 to -0.12, agitation/aggression: SMD = -0.37, 95 CI = -0.60 to -0.15) than placeboUC. However, yokukansan was not superior to placeboUC for BPSD total as well as any subscales scores only in Alzheimer's disease patients. Compared with UC, yokukansan treatment improved ADL scores (SMD = -0.32, 95 CI = -0.62 to -0.01). MMSE scores did not differ between the yokukansan and placeboUC treatment groups. No significant differences were found in all-cause discontinuation, discontinuation due to AEs, and incidences of AEs between yokukansan and placeboUC treatments. Conclusions: Our results suggest that yokukansan is beneficial for the treatment of patients with BPSD and is well-tolerated; it was not beneficial for BPSD total and any subscale scores only in Alzheimer's disease patients.
UR - http://www.scopus.com/inward/record.url?scp=84986570919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84986570919&partnerID=8YFLogxK
U2 - 10.3233/JAD-160418
DO - 10.3233/JAD-160418
M3 - Article
VL - 54
SP - 635
EP - 643
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 2
ER -