McMaster University researchers have found in a new meta-analysis that, contrary to previous warnings, donepezil, a drug commonly prescribed for dementia, poses no risk of death or certain heart rhythm problems. I found that it did not increase. research, Published in Journal of the American Geriatrics Societynoted that previous warnings about this class of drugs called cholinesterase inhibitors (ChEIs) classified them as “known risk” QT interval prolonging drugs (QTPmeds). However, they point out that this claim is derived only from observational data, including single case reports.
“We aimed to evaluate the high-quality literature on the frequency and nature of proarrhythmogenic major adverse cardiac events (MACE) associated with donepezil,” the researchers wrote.
More than 6 million prescriptions for donepezil were written in the United States in 2020. It has been prescribed to slow the progression of dementia symptoms such as memory loss, but questions remain about its effectiveness. Additionally, this drug can cause various side effects such as nausea, loss of appetite, urinary symptoms, and diarrhea.
McMaster researchers found that patients who were prescribed the drug had significantly lower rates of susceptibility related to the QT interval, the amount of time it takes for the heart’s electrical system to stimulate a heartbeat and then reset, compared to patients who were not prescribed the drug. An analysis was conducted to determine if they were more likely to develop fatal arrhythmias. medicine.
Researchers contacted Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Central to identify randomized controlled trials in patients aged 18 years and older that compared donepezil with placebo from 1996 to the present. Ta. The research team developed the MACE composite score, which includes mortality, sudden cardiac death, nonfatal cardiac arrest, torsade de pointes, ventricular tachycardia, seizures, or syncope.
In total, researchers analyzed 60 randomized clinical trials involving more than 12,000 people.
A more detailed analysis of the published study “found no association between donepezil and this particular fatal heart disease,” said co-lead author and Professor of Geriatrics at McMaster University School of Medicine. said Tina Nam, a fifth-year medical resident. “For prescribers, it’s good to know that donepezil may not pose as high a risk for this fatal arrhythmia as previously thought. For patients taking donepezil, donepezil There are concerns that it can cause some bad side effects on the heart, and this review helps clarify some of those long-held beliefs.”
The researchers found that several previous studies that had warned about these specific health risks of donepezil were missing because they included very small numbers of people or lacked a suitable comparison group. Therefore, this meta-analysis was necessary.
While they note that current dementia drugs, including donepezil, generally do not result in significant improvements in patient outcomes such as maintaining function at home, the researchers believe that these findings may reduce the risk of arrhythmia and related mortality. This should alleviate concerns about the increase, it said. .
“These reviews are extremely important in elucidating the preconceived risks associated with drugs like donepezil,” said co-lead author Cristian Garcia, a medical student at the University of Toronto’s Temerty School of Medicine. . “We can question the quality of the evidence to date and ask why things are the way they are. can be provided.”
