Efektivitas Citicoline dalam Terapi Demensia
DOI:
https://doi.org/10.55175/cdk.v51i1.990Kata Kunci:
demensia, citicoline, terapiAbstrak
Latar belakang: Dalam pengembangan terapi farmakologis untuk demensia, khususnya penyakit Alzheimer, beberapa jenis terapi yang banyak digunakan: penyekat acethylcholine esterase (acetylcholine esterase inhibitors/AChEI), penyekat reseptor N-methyl-D-aspartate (NMDA), dan prekursor kolinergik. Tujuan: Studi ini bertujuan untuk menelaah bukti terkait efektivitas suplementasi citicoline pada terapi standar untuk memperlambat progresi atau memperbaiki gejala pasien demensia. Metode: Penelusuran artikel studi uji klinis melalui tiga database: Pubmed, EBSCOhost, Scopus, dan Cochrane dalam kurun sepuluh tahun terakhir. Hasil: Dari 300 artikel yang didapat, lima studi diseleksi untuk ditelaah kritis. Empat studi menunjukkan peningkatan rerata MMSE kelompok citicoline + terapi standar (intervensi) dibandingkan kelompok terapi standar (kontrol) signifikan saat follow up pada 3–12 bulan. Satu studi menunjukkan peningkatan rerata MMSE kelompok intervensi yang signifikan pada follow up 12 bulan dibandingkan baseline. Simpulan: Suplementasi citicoline 1.000 mg/hari per oral pada terapi standar demensia jangka panjang mampu memberikan efek positif untuk fungsi kognitif pada pasien demensia. Hasil telaah validitas dan penerapan kelima studi menjadi pertimbangan aplikasi klinis sehari-hari.
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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.
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