Donepezil for cancer-related cognitive impairment: systematic review and meta-analysis
Abstract
Cancer-related cognitive impairment (CRCI) affects a significant proportion of cancer patients and survivors, impacting their memory, focus, mood, and quality of life. While non-pharmacological interventions have shown effectiveness in managing this condition, some studies have also explored various pharmacological agents, including donepezil, a reversible acetylcholinesterase inhibitor. This compound demonstrated beneficial effects on cognition in Alzheimer's disease; however, its effectiveness in CRCI remains unknown. This systematic review and meta-analysis aims to evaluate the efficacy of donepezil in improving cognitive outcomes in cancer patients. We conducted a search of PubMed/Medline, Embase, Cochrane Library, ClinicalTrials.gov, and the International Clinical Trials Registry Platform. Both randomized controlled trials and observational studies were included. We extracted data on cognitive outcomes of donepezil treatment, including the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test (TMT), and Controlled Oral Word Association Test (COWA), as well as reported adverse events (AEs). Out of 896 identified records, nine studies involving 837 patients met the inclusion criteria, including five RCTs and four observational studies. Donepezil failed to demonstrate significant improvements in cognitive outcomes in HVLT-R, TMT, and COWA. Fatigue, measured as a secondary outcome, also showed no significant improvement. AEs, such as insomnia and headache, were…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 837 participants or records.
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