Evidence map›Paper›PMID 40470403›Full record

ArticleCureus2025

Comparative Effectiveness of Rivastigmine and Donepezil in Patients With Alzheimer's Disease: A Retrospective Cohort Study.

Adeel Abbas Raja, Ammarah Amjad, Aeman Choudhary, Asma Atta, Maryam Atta, Shoukat Hussain, Marriam Khan

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Frontiers in pharmacology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Adeel Abbas RajaPharmacology, Azad Jammu Kashmir Medical College (AJKMC), Muzaffarabad, PAK.
Ammarah AmjadInternal Medicine, HBS (Hazrat Bari Imam Sarkar) Medical and Dental College, Rawalpindi, PAK.
Aeman ChoudharyPharmacology, HITEC-Institute of Medical Sciences (HITEC-IMS) Dental College, Rawalpindi, PAK.
Asma AttaMedicine, Azad Jammu Kashmir Medical College (AJKMC), Muzaffarabad, PAK.
Maryam AttaMedicine, Azad Jammu Kashmir Medical College (AJKMC), Muzaffarabad, PAK.
Shoukat HussainEndocrinology, Capital Hospital, Islamabad, PAK.
Marriam KhanHealth, Abbas Institute of Medical Sciences, Muzaffarabad, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This is a retrospective cohort study comparing the effectiveness of rivastigmine and donepezil in Alzheimer's disease (AD) patients. Of the 250 subjects, 127 (50.8%) were men, while 123 (49.2%) were women. Baseline cognitive function was assessed using the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). The results showed that 83 (33.2%) patients improved, 84 (33.6%) remained stable, and 83 (33.2%) experienced cognitive decline. The difference between the two groups was not significant with respect to cognitive outcomes (Chi-square = 0.08, df = 2, N = 250, p = 0.96). However, rivastigmine was associated with a higher rate of side effects (65, or 52%), which could hinder adherence. Both groups had an average of 1.48 hospitalization episodes per patient. Biomarker analysis suggested that 144 (57.6%) of patients tested positive for amyloid on positron emission tomography (PET) scans. Cerebrospinal fluid (CSF) analysis data, illustrated through mean values, showed amyloid beta at 546.38 pg/mL and tau at 219.85 pg/mL - both linked to cognitive decline. Higher levels of tau were significantly correlated with greater cognitive decline. Statistically, there were significant differences between the treatment groups in terms of MMSE scores and CSF biomarkers (p < 0.05). Although there was no statistically significant difference in cognitive outcomes between the drugs, subgroup analysis revealed significant differences in baseline MMSE scores and CSF biomarker levels (p < 0.05), suggesting heterogeneity in disease severity. Therefore, personalized strategies for managing patients with AD should be constructed based on the drug's side effect profile, comorbidities, and biomarker status. Future studies should focus on biomarker-directed and combination therapies to improve treatment efficacy.

Indexed as

alzheimer’s diseasebiomarkerscognitive declinedonepezilrivastigmine

Identifiers

PMID40470403
PMCPMC12135722

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.