Cerebrolysin for vascular dementia

Vascular dementia (VaD) is a common disorder which currently lacks definitive treatments. Cerebrolysin, a peptide preparation produced from purified pig brain proteins, seems to be a promising intervention based on animal studies and clinical trials in other conditions. We identified six trials involving 597 participants suitable for inclusion in this review. Pooled results showed improvements in cognitive function and global function in patients with VaD of mild to moderate severity, with no obvious side effects related to Cerebrolysin. However, due to the limited number of included trials, varying treatment durations and short-term follow-up, there is insufficient evidence to recommend Cerebrolysin as a routine treatment for patients with VaD.

Authors' conclusions: 

Cerebrolysin may have positive effects on cognitive function and global function in elderly patients with vascular dementia of mild to moderate severity, but there is still insufficient evidence to recommend Cerebrolysin as a routine treatment for vascular dementia due to the limited number of included trials, wide variety of treatment durations and short-term follow-up in most of the trials.

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Background: 

Vascular dementia is a common disorder without definitive treatments. Cerebrolysin seems to be a promising intervention based on its potential neurotrophic and pro-cognitive effects, but studies of its efficacy have yielded inconsistent results.

Objectives: 

To assess the efficacy and safety of Cerebrolysin for vascular dementia.

Search strategy: 

We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register on 4 November 2012 using the terms: Cerebrolysin, Cere, FPF1070, FPF-1070. ALOIS contains records of clinical trials identified from monthly searches of a number of major healthcare databases, numerous trial registries and grey literature sources.

Selection criteria: 

All randomized controlled trials of Cerebrolysin for treating vascular dementia without language restriction.

Data collection and analysis: 

Two authors independently selected trials and evaluated the methodological quality, then extracted and analysed data from the included trials.

Main results: 

Six randomized controlled trials with a total of 597 participants were eligible. The meta-analyses revealed a beneficial effect of Cerebrolysin on general cognitive function measured by mini-mental state examination (MMSE) (weighted mean difference (WMD) 1.10; 95% confidence interval (CI) 0.37 to 1.82) or Alzheimer's Disease Assessment Scale Cognitive Subpart, extended version (ADAS-cog+) (WMD -4.01; 95% CI -5.36 to -2.66). It also improved patients' global clinical function evaluated by the response rates (relative risk (RR) 2.71, 95% CI 1.83 to 4.00). Only non-serious adverse events were observed in the included trials, and there was no significant difference in occurrence of non-serious side effects between groups (RR 0.97, 95% CI 0.49 to 1.94).