Role of statins in Alzheimer's disease: a retrospective meta-analysis for commonly investigated clinical parameters in RCTs.

This review was conducted to assess the role of statins in the treatment of Alzheimer's disease (AD). We conducted meta-analysis using the randomised controlled trials (RCTs) conducted in patients who suffered from Alzheimer's disease, by conducting searches for RCTs in MEDLINE, EMBASE and Cochrane (up to 2012). An overall of five studies were included and analysed. The evaluation was done for some commonly evaluated clinical parameters like Clinical Global Impression of Change (CGIC), Mini Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale (ADAS-CoG). Statistical evaluation was done as per method described by Neyeloff et al. and forest plots were plotted for each evaluated parameter. MMSE score showed a significant difference in favour of statins. ADAS-CoG and CGIC did not show a significant advantage for statins in comparison to placebo. Highly heterogeneous distribution was seen for MMSE score. Further trials need to be conducted to arrive at more robust results.

Evaluation of Quality of Pharmacoeconomic Studies in Asia-Pacific Region and Identification of Influencing Variables.

OBJECTIVES: To assess the quality of pharmacoeconomic studies and identify different variables influencing the quality of these studies conducted in the Asia-Pacific (APAC) region. METHODS: A systematic literature search was performed with PubMed and Cochrane using different combinations of terms for cost-effectiveness, cost-utility, and cost-minimization analyses. The Quality of Health Economic Studies (QHES) instrument was used for quality assessment of included studies. Logistic regression was performed to determine the association of factors with high-quality studies (QHES score ≥75). RESULTS: Of 262 retrieved studies, 128 met the inclusion criteria. The mean QHES score was 67.4 ± 1.35. The distribution of studies in each quality quartile was as follows: high (n = 59 [46.09%]), fair (n = 50 [39.06%]), and poor (n = 19 [14.83%]). Most of the high-quality studies (n = 80 [62.5%]) were conducted in Japan and Australia. Only 11 high-quality studies (18.64%) were published in specialty journals and 4 (6.78%) in Asian journals. Primary authors who had advanced training in health economics were associated with a higher number of high-quality studies (n = 51 [86.44%]). Training of primary authors was significantly associated with high-quality studies (odds ratio 7.1; 95% confidence interval 2.9-19.23). Impact factor of journal, per-capita expenditure on health care, and out-of-pocket expense on health did not have a significant association with high-quality scores. CONCLUSIONS: High-quality pharmacoeconomic research is confined to a few countries of the APAC; it can be improved by advance training of authors in public health or health economics. Also, a greater interest of various stakeholders in funding the research and the introduction of specialty journals in the APAC are warranted.

Role of traditional nonsteroidal anti-inflammatory drugs in Alzheimer's disease: a meta-analysis of randomized clinical trials.

The role of nonsteroidal anti-inflammatory drugs (NSAIDs) in prevention of Alzheimer's disease (AD) has been evaluated in many studies. We performed a meta-analysis to summarize the existing evidence on the relation between use of classical NSAIDs and AD. Randomized controlled trials (RCTs) evaluating the role of classical NSAIDs in AD was searched using different search engines. The RCTs in patients who had the degree of AD measured on Mini-Mental State Examination (MMSE) or AD Assessment Scale-Cognitive subscale (ADAS-cog) were included in the study. The RCTs and data (AD scores) were independently assessed by 2 reviewers, and data were included in meta-analysis only after a common consensus was reached. The pooled results from the ADAS-cog and MMSE scores failed to show any difference between the treatment and the placebo groups as opposed to findings from some observational studies. However, in view of heterogeneity of results, there is a need to conduct more RCTs to arrive at confirmatory findings.

Prescription pattern in asthma therapy at Gorakhpur hospitals.

OBJECTIVES: This prescription-monitoring study was conducted to establish the drug-prescribing trend of anti-asthmatic drugs in various hospitals of Gorakhpur. SETTING: The study covered three famous hospitals of Gorakhpur. PATIENTS AND METHODS: Hundred patients were studied using a prescription auditing performa. Data was recorded from the patient's attending the out patient department using a chance random sample method for two months. Patients who co- operated were interviewed and information was filled in the performa. RESULTS: The results suggested that b-agonist (40%) were the most frequently prescribed anti-asthmatic drugs followed by Methylxanthine (27%), corticosteroids (25%), leukotriene antagonist (4.4%) and anti-histaminics (3.6%) was the least prescribed. Analysis of prescription revealed that multiple drug therapy (81%) was opted for a significant number of patients as compared to single drug therapy (19%). Contrary to popular belief, oral dosage form tablets (56.3%) were preferred over inhalation (33.8%). CONCLUSION: It is concluded that the present prescribing pattern of anti-asthmatics in Gorakhpur does not completely meet standard guidelines of asthma treatment. Hence there is a need to encourage physicians of Gorakhpur to follow the guidelines while treating asthma.