Efektivitas Citicoline dalam Terapi Demensia

Authors

  • Mawaddah Ar Rochmah Dokter Spesialis Neurologi, Departemen Neurologi, FK-KMK, UGM
  • Erupsiana Fitri Indrihapsari KSM Neurologi, RS PKU Muhammadiyah Surakarta
  • Dhite Bayu Nugroho Departemen Ilmu Penyakit Dalam, FK-KMK, UGM

DOI:

https://doi.org/10.55175/cdk.v51i1.990

Keywords:

dementia, citicoline, therapy

Abstract

Background: In the development of pharmacological therapy for dementia, especially Alzheimer's disease, several types of therapy are widely used: acethylcholine esterase inhibitors/AChEI, N-methyl-D-aspartate (NMDA) receptors inhibitors, and cholinergic precursor. Aim: To review the evidence on the effectiveness of citicoline supplementation to the standard therapy of dementia to prevent the progression or improve the manifestations of dementia. Methods: A literature search was performed in three following databases: Pubmed, EBSCOhost, Scopus, and Cochrane within the last ten years. Results: Of the 239 articles, five studies were eligible for critical appraisal. Four studies showed a significant mean MMSE score increase in the citicoline + standard therapy group (intervention) compared to the standard therapy group (control) during the follow up period between 3 – 12 months. One study showed a significant mean MMSE score increase of in the intervention group compared to the control group. Conclusion: Oral citicoline supplementation of 1,000 mg/day to the standard therapy showed a positive effect on cognitive function in dementia patients. Critical appraisal of validity and application of the included studies should be considered upon daily clinical application.

Downloads

Download data is not yet available.

References

Gale SA, Acar D, Daffner KR. Dementia. Am J Med. 2018 Oct;131(10):1161-9.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-9.

World Alzheimer Report. World Alzheimer report 2013. Journey of Caring. An analysis of long-term care for dementia [Internet]. 2013. Available from: https://www.alzint.org/u/WorldAlzheimerReport2013.pdf.

Gareri P, Cotroneo AM, Orsitto G, Putignano S. The CITIMEM study: A pilot study. Optimizing pharmacological treatment in dementia. Arch Gerontol Geriatr. 2020;89:104073.

Mangialasche F, Solomon A, Winblad B, Mecocci P, Kivipelto M. Alzheimer's disease: Clinical trials and drug development. Lancet Neurol. 2010;9(7):702-16.

Birks JS, Cochrane Dementia and Cognitive Improvement Group. Cholinesterase inhibitors for Alzheimer's disease. Cochrane database of systematic reviews. 1996;2016(3).

Cacabelos R, Takeda M, Winblad B. The glutamatergic system and neurodegeneration in dementia: Preventive strategies in Alzheimer's disease. Int J Geriatr Psychiatry 1999;14(1):3-47.

Castagna A, Manzo C, Fabbo A, Lacava R, Ruberto C, Ruotolo G. The Citimeriva study: Citicoline plus memantina plus rivastigmine in older patients affected with Alzheimer’s disease. Clin Drug Investig. 2021;41:177-82.

Fioravanti M, Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD000269.

Hurtado O, Lizasoain I, Moro MÁ. Neuroprotection and recovery: Recent data at the bench on citicoline. Stroke 2011;42(1_suppl_1):S33-5.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

Castagna A, Cotroneo AM, Ruotolo G, Gareri P. The CITIRIVAD study: CITIcoline plus RIVAstigmine in elderly patients affected with dementia study. Clinical Drug Investig. 2016;36:1059-65.

Gareri P, Castagna A, Cotroneo AM, Putignano D, Conforti R, Santamaria F, et al. The citicholinage study: Citicoline plus cholinesterase inhibitors in aged patients affected with Alzheimer’s disease study. J Alzheimer's Dis. 2017;56(2):557-65.

Castagna A, Fabbo A, Manzo C, Lacava R, Ruberto C, Ruotolo G. A retrospective study on the benefits of combined citicoline, memantine, and acetylcholinesterase inhibitor treatments in older patients affected with Alzheimer’s disease. J Alzheimer's Dis. 2021 Jan 1;79(4):1509-15.

Howick J, Chalmers I, Lind J, Glasziou P, Greenhalgh T, Heneghan C, et al. Oxford Centre for evidence-based medicine 2011 levels of evidence [Internet]. Available from: http://www.cebm.net/index.aspx?o=5653

Bonvicini M, Travaglini S, Lelli D, Antonelli Incalzi R, Pedone C. Is citicoline effective in preventing and slowing down dementia? A systematic review and a meta-analysis. Nutrients 2023;15(2):386.

Andrews JS, Desai U, Kirson NY, Zichlin ML, Ball DE, Matthews BR. Disease severity and minimal clinically important differences in clinical outcome assessments for Alzheimer's disease clinical trials. Alzheimer's & Dementia 2019;5(1):354-63.

Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiat Res. 2009;43(4):411-31.

Jasielski P, Piędel F, Piwek M, Rocka A, Petit V, Rejdak K. Application of citicoline in neurological disorders: A systematic review. Nutrients 2020;12(10):3113.

Emril DR, Wibowo S, Meliala L, Susilowati R. Cytidine 5-diphosphocholine administration prevents peripheral neuropathic pain after sciatic nerve crush injury in rats. J Pain Res. 2016;23:287-91.

Published

02-01-2024

How to Cite

Ar Rochmah, M., Indrihapsari, E. F., & Nugroho, D. B. (2024). Efektivitas Citicoline dalam Terapi Demensia. Cermin Dunia Kedokteran, 51(1), 37–43. https://doi.org/10.55175/cdk.v51i1.990