A Rebuild the Evidence-Base-reading of cholinesterase inhibitors' effect on all-cause mortality in patients with dementia.

ABSTRACT

We propose a new reading of the results of a solid systematic review published in 2022 in Neurology by Truong et al. comparing cholinesterase inhibitors (ChEIs) treatment to placebo or no treatment on all-cause mortality in patients with any type of dementia. Leaving ethical considerations aside, we tested if another method of interpretation of the results of the systematic review would yield different results. We applied the "Rebuild the Evidence Base" method to the data extracted from the meta-analysis and found that the positive result of the meta-analysis (P = .01) and the lack of heterogeneity did not weigh enough in the balance against the strictly exploratory nature of all the results of the individual randomized controlled trials included and the suspected publication bias. There was a lack of evidence of effect of ChEI treatment on overall mortality in patients with dementia.